NPIMap

Organization Active NPI

Juspen Behavioral Associates.

  • Psychiatry Physician
  • Fort Washingtion, MD
National Provider Identifier
1669015145
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JUSPEN BEHAVIORAL ASSOCIATES.
Practice address
11703 Amer CT
Fort Washingtion, MD 20744-2164
Phone
(301) 702-0047
NPI assigned
Oct 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Authorized official

Name
Judie Johnson, LN
Title
Ceo
Phone
(301) 702-0047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

11703 Amer CT
Fort Washingtion, MD 20744-2164

Mailing address

11703 Amer CT
Fort Washingtion, MD 20744-2164
Phone (301) 702-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219000729 DC Part B Supplier - Clinic/Group Practice 8426485152 Receives reassigned benefits from 7 practitioners
Practice locations: Camp Springs, MD

National Provider Directory

National Provider Directory
Tax ID family
Juspen Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1669015145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 AMER CT",
            "city": "FORT WASHINGTION",
            "state": "MD",
            "postal_code": "207442164",
            "telephone_number": "301-702-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 AMER CT",
            "city": "FORT WASHINGTION",
            "state": "MD",
            "postal_code": "207442164",
            "telephone_number": "301-702-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSPEN BEHAVIORAL ASSOCIATES.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JUDIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-702-0047",
        "authorized_official_credential": "LN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.