Ronald Bruce Johnson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2177-057 Issued in WI

Practice address

336 Lodi St
Lodi, WI 53555-1418

Phone

(608) 592-2080

Fax

(608) 592-7120

NPI assigned

Jun 22, 2006

Last updated

Mar 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Midlands Psychological Associates, LLC

  • Clinical Psychologist
  • Lodi, WI
  • NPI 1285676593
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1598701906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 LODI ST",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551418",
            "telephone_number": "608-592-2080",
            "fax_number": "608-592-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 LODI ST",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551418",
            "telephone_number": "608-592-2080",
            "fax_number": "608-592-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RONALD",
        "middle_name": "BRUCE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2177-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39127800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lea Haak, APRN
• Stacey Lee Hamre, RN
• Jennifer Lynn Hankwitz, RN
• Richard Carl Harris, R.PH.
• Adonnas Kay Johnson, PHARMD
• Colleen R Jones
• Christine Michele Kinsman, RN
• Cara Kjorlie, LPN
• Jocelyn Koerner
• Kathryn A Kraft, PT

• Clinical Psychologist in Lodi, WI
• Providers in Lodi, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.