Walter Sir Anthony Johnson III, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

130 Carbonton Rd
Sanford, NC 27330-4009

Phone

(919) 774-6521

Fax

(919) 776-6179

NPI assigned

Jun 21, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Integrated Behavioral Healthcare Services, PA

  • Psychologist
  • Fayetteville, NC
  • NPI 1689842551
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1477047561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CARBONTON RD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304009",
            "telephone_number": "919-774-6521",
            "fax_number": "919-776-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WALTER",
        "middle_name": "SIR ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012728",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brettny John
• Johnson Owens Transportation LLC
• Alivia Nicole Johnson
• Imani Nia Johnson, MS, MSW, LCSWA
• May PA Tha Johnson
• Jonathan D. Mosley, DDS, P.a.
• Sadequa Jones-McQueen, HAIR LOSS SPECIALIST
• Faith Ann Jones, MS, CF-SLP
• John Fletcher Jones, M.D.
• Lisa Llewellyn Jones, M.D.

• Clinical Social Worker in Sanford, NC
• Providers in Sanford, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.