Deidra McGie Johnson, LCP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

1102 S. Rouse
Pittsburg, KS 66762

Phone

(620) 231-5310

Fax

(620) 231-9893

NPI assigned

Aug 22, 2007

Last updated

Oct 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Deidra Louise McGie Former name

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southeast Kansas Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Humboldt, KS
  • NPI 1467414771
  Medicare reassignment NPD
• Dccca, Inc

  dba DCCCA Behavioral Health Pittsburg

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pittsburg, KS
  • NPI 1861793556
  NPD (past)
• Dccca, Inc.

  dba Elm Acres Recovery-Pittsburg Outpatient

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pittsburg, KS
  • NPI 1417076001
  NPD (past)

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1568655637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S. ROUSE",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-5310",
            "fax_number": "620-231-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S. ROUSE",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-5310",
            "fax_number": "620-231-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEIDRA",
        "middle_name": "MCGIE",
        "name_prefix": "Mrs.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KS",
            "license": "LCP - 269",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "KS",
            "license": "LCP - 269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIDRA",
            "last_name": "MCGIE",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "credential": "LMLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Marie Jenkins
• Christine Faye Jenkins, LMSW
• Kyra Dawn Jent, APRN FNP
• John D Taylor MD PA
• Valorie L Johnson-Hall, CRNA
• Emily Ann Johnson, FNP-C
• Julie Anne Johnson, P.T.
• Katelyn Johnson
• Lesley Johnson, RDH
• Melissa K Johnston, FNP, PMHNP

• Clinical Child & Adolescent Psychologist in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Clinical Child & Adolescent Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.