Randy J. Johnson, LCMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3008 Issued in NC

Practice address

2235 Lewisville Clemmons Rd Ste a
Clemmons, NC 27012-9342

Phone

(336) 722-7266

Fax

(336) 201-0538

NPI assigned

Mar 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

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

Mental Health Counselor

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capstone Wellness CenterGroup PAC ID 9133482383, 5 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 and National Provider Directory roles.

• Capstone Wellness Center

  • Professional Counselor
  • Sparta, NC
  • NPI 1780008870
  Medicare reassignment Care Compare group NPD
• Wellmood PLLC

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1154182368
  NPD (past)
• Complete Care Partners LLC

  • Family Medicine Physician
  • El Paso, TX
  • NPI 1114437563
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1790745404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 S MARSHALL ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015808",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 LEWISVILLE CLEMMONS RD STE A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129342",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 State Farm Rd",
            "address_2": "Suite 508",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074917",
            "country_code": "US",
            "telephone_number": "828-264-9007",
            "fax_number": "828-262-5687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RANDY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102482",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1236V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D9674",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102747",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D0751",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Evey Jennings
• Kyle Joseph Jensen
• Candice Darcy Johnson-Leonard, ANP-C
• Kimberly D Johnson
• Melissa Ann Johnson, LCSW, LCAS, CCS
• Brandi Lelia Holmes Jones, PA-C
• Colton Jones, PHARMD
• Jada Jordan
• Nicholaos Kalogeromitros
• Kareem Redmond DDS PLLC

• Professional Counselor in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.