Individual provider Active NPI

Lisa Jaynes Johnson, LMFT

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1477599249
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1710 Issued in NM
Practice address
3214 Purdue PL NE
Albuquerque, NM 87106-2124
Phone
(505) 288-2162
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1710 NM Primary

Addresses

Primary practice location

3214 Purdue PL NE
Albuquerque, NM 87106-2124

Mailing address

817 Carlisle Blvd NE
Albuquerque, NM 87106-1209
Phone (505) 288-2162

Other identifiers 6

IdentifierTypeStateIssuer
Z7949MedicaidNM
NM100184OtherNMVALUE OPTIONS NM
112391OtherNMVALUE OPTIONS PPO
87726OtherNMUNITED HEALTH PLAN
10001443OtherNMLOVELACE HEALTH PLAN
NM02JE00OtherNMBLUE CROSS BLUE SHEILD ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729004458 NM Practitioner - Marriage and Family Therapist 9638616428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3335 Monte Vista Blvd NE
Albuquerque, NM 87106-2121
Phone (505) 288-2162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1710NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa J Johnson LMFT LLC Marriage & Family Therapist CurrentSince Jul 17, 2024 Accepting new patients

Locations

3214 Purdue Pl NE
Albuquerque, NM 87106
Phone (505) 385-0161

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477599249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061209",
            "telephone_number": "505-288-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 PURDUE PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062124",
            "telephone_number": "505-288-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "JAYNES",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "1710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z7949",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS NM",
            "identifier": "NM100184",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PPO",
            "identifier": "112391",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLAN",
            "identifier": "87726",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH PLAN",
            "identifier": "10001443",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD ID",
            "identifier": "NM02JE00",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.