Clarence McNeil Johnson Jr., CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AC002607 Issued in MD

Practice address

7450 Albert Rd FL 2
Brandywine, MD 20613-3035

Phone

(301) 888-2233

Fax

(301) 888-9133

NPI assigned

Oct 9, 2018

Last updated

Feb 17, 2023By the provider in NPPES

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 MD, DC, SC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Baden Medical Service IncorporatedGroup PAC ID 4981632650, shared by 10 NPIs, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reflective Minds Mental Wellness, LLC

  • Psychiatry Physician
  • Waldorf, MD
  • NPI 1255097838

  SC

  Medicare reassignment NPD Authorized official
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Brandywine, MD
  • NPI 1912927344

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
  • NPI 1487469243
  NPD
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1275783615
  NPD (past)
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • La Plata, MD
  • NPI 1417107913
  NPD (past)
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Leonardtown, MD
  • NPI 1922258367
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1740755594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 3",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 2",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233",
            "fax_number": "301-888-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLARENCE",
        "middle_name": "MCNEIL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC002607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559402201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JLP Services, LLC
• JM Group Homes
• Joan Healthcare Servces
• Johns Hopkins Community Physicians (JHCP - 7704 Matapeake Business Dr)
• Johns Hopkins Community Physicians, Inc (JHCP - 7704 Matapeake Business Dr Ste 110 - Provider Type: 20 - Physician)
• Delores Michelle Johnson
• Derrick Jerod Johnson, MS
• Ka'Ra Caprie Johnson, LCSW-C, LCSW
• Anita Bonsu Jones, MD
• Just Breathe Recovery and Wellness Centers, LLC

• Psychiatric/Mental Health Nurse Practitioner in Brandywine, MD
• Providers in Brandywine, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.