Organization Active NPI

Starlight Clinic PLLC

  • Child & Adolescent Psychiatry Physician
  • Johnston, IA
National Provider Identifier
1801764394
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
STARLIGHT CLINIC PLLC
Practice address
6701 Corporate Dr # 4251
Johnston, IA 50131-1659
Phone
(319) 212-8116
NPI assigned
Oct 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Burgundy Johnson, DONPI 1548608847
Title
Psychiatrist
Phone
(319) 212-8116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

6701 Corporate Dr # 4251
Johnston, IA 50131-1659

Mailing address

6701 Corporate Dr # 4251
Johnston, IA 50131-1659

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1801764394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 CORPORATE DR # 4251",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 CORPORATE DR # 4251",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311659",
            "telephone_number": "319-212-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BURGUNDY",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "319-212-8116",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.