Individual provider Active NPI

John A Johnson, M.D., MBA

  • Psychiatry Physician
  • New Albany, OH
National Provider Identifier
1720154131
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35069048 Issued in OH
Practice address
4319 Vaux Link
New Albany, OH 43054-9683
Phone
(614) 225-0400
Fax
(800) 948-7705
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35069048 OH Primary

Addresses

Primary practice location

4319 Vaux Link
New Albany, OH 43054-9683

Mailing address

4319 Vaux Link
New Albany, OH 43054-9683
Phone (614) 225-0400

Other identifiers 1

IdentifierTypeStateIssuer
0173459MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040207000449 OH Practitioner - PsychiatryPractitioner - Addiction MedicinePractitioner - Geriatric Psychiatry 5597658955 Reassigns benefits to 3 organizations
Practice locations: Union City, OH; Springfield, OH; South Vienna, OH; New Paris, OH; Lucasville, OH; Dayton, OH; Centerburg, OH; Cardington, OH…

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine, Geriatric Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Behavioral LLCGroup PAC ID 1052595402, 23 clinicians

Practice addresses (Care Compare)

4725 Parkwick Dr
Suite 109
Columbus, OH 43228-6401
Phone (614) 985-3112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35069048OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Ohio, LLC CurrentSince May 15, 2006 Accepting new patients
Cambridge Developmental Center CurrentSince Mar 1, 2016 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
Access Behavioral LLC Psychiatry CurrentSince Feb 20, 2011 Accepting new patients
Access Ohio, LLC CurrentSince Mar 6, 2013 Accepting new patients
Access Hospital Dayton LLC PastSince Apr 2, 2010 Accepting new patients
Jeffrey Fley DPM LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Access Behavioral LLC Past Accepting new patients
East Ohio Hospital LLC PastSince Apr 28, 2020 Accepting new patients
Access Behavioral LLC Past Accepting new patients
Access Behavioral LLC PastSince Aug 2, 2020 Accepting new patients

Locations

4725 Parkwick Dr
Ste 109
Columbus, OH 43228
Phone (614) 985-3112

899 E Broad St
Columbus, OH 43205
Phone (614) 252-0771

6400 E Broad St
Ste 400
Columbus, OH 43213
Phone (614) 367-7700

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

99 N Brice Rd
Ste 360
Columbus, OH 43213
Phone (614) 367-7700

1601 W Broad St
Columbus, OH 43222
Phone (614) 272-0509

4725 Parkwick Dr
Ste 100
Columbus, OH 43228
Phone (614) 655-3354

8100 Ravines Edge Ct
Ste 200
Columbus, OH 43235
Phone (614) 655-3345

2611 Wayne Ave
Dayton, OH 45420
Phone (937) 228-0579

2611 Wayne Ave
Bldg 61
Dayton, OH 45420
Phone (937) 228-0579

Interoperability endpoints

  • Direct secure messaging: john.johnson@glacecentral.com

Organizations & group practices 12

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1720154131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 VAUX LINK",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549683",
            "telephone_number": "614-225-0400",
            "fax_number": "800-948-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 VAUX LINK",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549683",
            "telephone_number": "614-225-0400",
            "fax_number": "800-948-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "M.D., MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35069048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173459",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, OH

Sources for this page

Verify at the official NPI Registry.