Individual provider Active NPI

Charles Raymond Johnson Jr., L.C.S.W.

  • Clinical Social Worker
  • Plymouth Meeting, PA
National Provider Identifier
1528311701
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00494900 Issued in NJ
Practice address
2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Phone
(610) 834-1122
NPI assigned
Oct 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00494900 NJ Primary

Addresses

Primary practice location

2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047

Mailing address

34 Buena Vista Ave
Piscataway, NJ 08854-4863
Phone (732) 743-9317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Medical of Ca PC Past Accepting new patients

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": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1528311701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 BUENA VISTA AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544863",
            "telephone_number": "732-743-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "address_2": "SUITE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "610-834-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00494900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.