Individual provider Active NPI

Tony Alan Johnson, PH.D.

  • Psychologist
  • Newnan, GA
National Provider Identifier
1699890418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY001788 Issued in GA
Practice address
45B Sutherland Dr
Newnan, GA 30263-1455
Phone
(770) 683-3512
Fax
(770) 683-3513
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY001788 GA Primary

Addresses

Primary practice location

45B Sutherland Dr
Newnan, GA 30263-1455

Mailing address

45B Sutherland Dr
Newnan, GA 30263-1455
Phone (770) 683-3512

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001788GAMDPsychologist
1788GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skinner and Associates P.C. Psychologist Past Accepting new patients
Newnan Psychological Services Psychologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699890418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45B SUTHERLAND DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631455",
            "telephone_number": "770-683-3512",
            "fax_number": "770-683-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45B SUTHERLAND DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631455",
            "telephone_number": "770-683-3512",
            "fax_number": "770-683-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TONY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

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.

Verify at the official NPI Registry.