Active NPI
John David Johnson, BCBA, LBA
- Behavior Analyst
- Matamoras, PA
National Provider Identifier
1598285603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 001408
- Practice address
- 401 Avenue G
Matamoras, PA 18336-1303 - Phone
- (570) 856-2525
- NPI assigned
- Jun 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 71-001408 | NY | |
| Behavior Analyst | 103K00000X | 001408 | NY | Primary |
Addresses
Primary practice location
401 Avenue G
Matamoras, PA 18336-1303
Mailing address
401 Avenue G
Matamoras, PA 18336-1303
Phone (570) 856-2525
Other practice location 1
606 State Route 17
Monticello, NY 12701
Phone (845) 707-8400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71-001408 | NY | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buckeye Behavioral Consulting Inc | Past | Accepting new patients | |
| The Center for Discovery Inc | Past | Accepting new patients |
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.
-
- Clinic/Center
- Beavercreek, OH
- NPI 1902369309
-
- Rural Health Clinic/Center
- Monticello, NY
- NPI 1275624694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678406400000",
"number": "1598285603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 AVENUE G",
"city": "MATAMORAS",
"state": "PA",
"postal_code": "183361303",
"telephone_number": "570-856-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 AVENUE G",
"city": "MATAMORAS",
"state": "PA",
"postal_code": "183361303",
"telephone_number": "570-856-2525"
}
],
"practiceLocations": [
{
"address_1": "606 State Route 17",
"address_purpose": "LOCATION",
"city": "Monticello",
"state": "NY",
"postal_code": "12701",
"country_code": "US",
"telephone_number": "845-707-8400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOHN",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "BCBA, LBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-21",
"last_updated": "2023-03-10",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "71-001408",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "001408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matamoras, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.