Dan Johnson, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0110P Issued in AR

Practice address

1201 Fleming Ave
Jonesboro, AR 72401

Phone

(870) 933-5174

Fax

(870) 933-5235

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Merit-based Incentive Payment System (MIPS)

Final score

22.71 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

75.7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dan Johnson PHD Clinical Neuropsychologist,P.a.

  • Specialist
  • Jonesboro, AR
  • NPI 1174661003
  Medicare reassignment NPD Authorized official
• Clinical Neuropsych, PA

  • Community/Behavioral Health Agency
  • Jonesboro, AR
  • NPI 1740579069
  NPD (past) Authorized official
• Medical Rehab Group LLP

  • Family Medicine Physician
  • Jonesboro, AR
  • NPI 1669856704
  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Bernards Hospital Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720004716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FLEMING AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-933-5174",
            "fax_number": "870-933-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FLEMING AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-933-5174",
            "fax_number": "870-933-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "0110P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "5F374",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bran'Dajah Johnson
• Brianne Alexandra Johnson
• Brittney Johnson, CHES
• Christopher Johnson
• Dalton Johnson, DNP
• Deborah Ann Johnson, M.D.
• Dejah Marie Johnson
• Derek D Johnson
• Dyzamona Johnson
• Hannah Katherine Johnson, COTA

• Clinical Neuropsychologist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Neuropsychologist in Arkansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.