Sandra K Johnston, PHD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3184-57 Issued in WI

Practice address

120 Wyldewood Dr
#B202
Oshkosh, WI 54904-8631

Phone

(920) 479-8178

NPI assigned

Nov 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Valley Vna Health Systems Inc

  • Voluntary or Charitable Agency
  • Neenah, WI
  • NPI 1992783856
  NPD (past)

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1811299126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WYLDEWOOD DR",
            "address_2": "#B202",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048631",
            "telephone_number": "920-479-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WYLDEWOOD DR",
            "address_2": "#B202",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048631",
            "telephone_number": "920-479-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SANDRA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4407-125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15657-131",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3184-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100015347",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Beth Johnson
• Scott B Johnson, MD
• Tayla Johnson
• Caitlin Johnston, PA-C
• Kimberly Johnston
• Jones Family Chiropractic, LLC
• Andrew Preston Jones
• Jeffrey J Jones, MD
• Robert Walter Jones Jr., M.D.
• Shanequa Jones

• Psychologist in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.