David Richard Johnson, M.S., MSAOM, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00053200 Issued in NJ

Practice address

1156 E Ridgewood Ave
Suite 4
Ridgewood, NJ 07450-3935

Phone

(201) 670-8443

Fax

(201) 612-7654

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1497804553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SUMMIT AVE",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631915",
            "telephone_number": "201-670-8443",
            "fax_number": "201-612-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 E RIDGEWOOD AVE",
            "address_2": "SUITE 4",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503935",
            "telephone_number": "201-670-8443",
            "fax_number": "201-612-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "M.S., MSAOM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SW05189900",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "44SW05189900",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SW05189900",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00053200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY ACUPUNCTURE LICENSE NUMBER",
            "identifier": "25MZ00053200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.