Individual provider Active NPI

Katrina Johnson, PSYD

  • Psychologist
  • Madison, WI
National Provider Identifier
1578043493
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3586-57 Issued in WI
Practice address
2202 S Park St
Madison, WI 53713
Phone
(608) 443-5480
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3586-57 WI Primary
Clinical Social Worker 1041C0700X 3586-57 WI

Addresses

Primary practice location

2202 S Park St
Madison, WI 53713

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190308001680 WI Practitioner - Clinical Psychologist 8123367174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1102 S Park St
Madison, WI 53715-1708
Phone (608) 263-3111

2202 S Park St
Madison, WI 53713-1916
Phone (608) 443-5480

3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3586-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Centers, Inc. CurrentSince Jan 19, 2019 Accepting new patients
Access Community Health Centers, Inc. CurrentSince Jan 19, 2019 Accepting new patients

Locations

2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500

2202 S Park St
Madison, WI 53713
Phone (608) 443-5480

Interoperability endpoints

  • Direct secure messaging: kjohnson845240@direct.uwhealth.org

Organizations & group practices 2

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1578043493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53713",
            "telephone_number": "608-443-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATRINA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3586-57",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3586-57",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.