Individual provider Active NPI

Catherine Maria Johnson-Ford, PH.D.

  • Clinical Psychologist
  • Orange Park, FL
National Provider Identifier
1639288434
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12546 Issued in FL
Practice address
538 Park Ave Ste 2
Orange Park, FL 32073-3111
Phone
(512) 842-2223
NPI assigned
Aug 29, 2006
Last updated
Jun 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 25350 TX
Clinical Psychologist 103TC0700X PY12546 FL Primary

Addresses

Primary practice location

538 Park Ave Ste 2
Orange Park, FL 32073-3111

Mailing address

538 Park Ave Ste 2
Orange Park, FL 32073-3111
Phone (512) 842-2223

Other identifiers 2

IdentifierTypeStateIssuer
1655045-03MedicaidTX
0026JZOtherTXBCBS

Other names 1

  • Catherine Maria Ford Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040628001179 TX Practitioner - Clinical Psychologist 1850377045 Practice locations: Austin, TX
I20250122001184 FL Practitioner - Clinical Psychologist 1850377045 Practice locations: Orange Park, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1221 W Ben White Blvd
Suite 108a
Austin, TX 78704-7183
Phone (512) 842-2223

538 Park Ave
Suite 2
Orange Park, FL 32073-3111
Phone (512) 842-2223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY12546FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Neuropsychology of Austin PastSince Apr 9, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1639288434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 PARK AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733111",
            "telephone_number": "512-842-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 PARK AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733111",
            "telephone_number": "512-842-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-FORD",
        "first_name": "CATHERINE",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "25350",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1655045-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0026JZ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "FORD",
            "middle_name": "MARIA",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.