Individual provider Active NPI

Earl E Johnson, AU.D. PH.D.

  • Audiologist
  • Mountain Home, TN
National Provider Identifier
1558532234
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1388 Issued in TN
Practice address
Dogwood Ave
BLDG 204 Audiology-126
Mountain Home, TN 37684-4000
Phone
(423) 926-1171
NPI assigned
Mar 20, 2008
Last updated
May 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 7980 NC
Audiologist 231H00000X 1388 TN Primary

Addresses

Primary practice location

Dogwood Ave
BLDG 204 Audiology-126
Mountain Home, TN 37684-4000

Mailing address

PO Box 4000
Audiology-126
Mountain Home, TN 37684-4000
Phone (423) 926-1171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007000128 TN Practitioner - Qualified Audiologist 0840424933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1388TNMDClinical Psychologist
7980NCMDAudiologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1558532234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "address_2": "AUDIOLOGY-126",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DOGWOOD AVE",
            "address_2": "BLDG 204 AUDIOLOGY-126",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EARL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "AU.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-20",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "7980",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "1388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.