Active NPI
Richard Kenneth Johnson, PSYCHOLOGIST
- Psychologist
- Louisville, KY
National Provider Identifier
1609891605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0277
- Practice address
- 101 W Muhammad Ali Blvd
Louisville, KY 40202-1423 - Phone
- (502) 589-8600
- Fax
- (502) 589-8771
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0277 | KY | Primary |
Addresses
Primary practice location
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Mailing address
230 Yager Ave
Ste 5
Lagrange, KY 40031-1060
Phone (502) 589-1100
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0277 | KY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609891605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 YAGER AVE",
"address_2": "STE 5",
"city": "LAGRANGE",
"state": "KY",
"postal_code": "400311060",
"telephone_number": "502-589-1100",
"fax_number": "502-589-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W MUHAMMAD ALI BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021423",
"telephone_number": "502-589-8600",
"fax_number": "502-589-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "RICHARD",
"middle_name": "KENNETH",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "0277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.