Individual provider Active NPI

Julia B Johnson, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1679574602
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000000450 Issued in TN
Practice address
3950 Central Avenue
Memphis, TN 38111-7602
Phone
(901) 458-6291
Fax
(901) 323-4848
NPI assigned
Aug 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LSW0000000450 TN
Clinical Social Worker 1041C0700X LSW0000000450 TN Primary

Addresses

Primary practice location

3950 Central Avenue
Memphis, TN 38111-7602

Mailing address

3950 Central Avenue
Memphis, TN 38111-7602
Phone (901) 458-6291

Other identifiers 2

IdentifierTypeStateIssuer
4026792OtherTNTN BLUE CROSS BLUE SHIELD
2002938OtherTNCIGNA

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

LicenseStateTypeSpecialty
LSW0000000450TNMDClinical Social Worker
450TNMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1679574602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381117602",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381117602",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JULIA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LSW0000000450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000000450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BLUE CROSS BLUE SHIELD",
            "identifier": "4026792",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2002938",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.