Individual provider Active NPI

John Duane Pierson, M.D.

  • Psychiatry Physician
  • Clearwater, FL
National Provider Identifier
1861484677
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME10342 Issued in FL
Practice address
555 S Duncan Ave
Clearwater, FL 33756
Phone
(727) 303-3995
Fax
(727) 242-2335
NPI assigned
Aug 17, 2005
Last updated
Jun 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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 ME10342 FL Primary

Addresses

Primary practice location

555 S Duncan Ave
Clearwater, FL 33756

Mailing address

555 S Duncan Ave
Clearwater, FL 33756-6255
Phone (727) 303-3995

Other practice location 1

2189 Cleveland St
Suite G207
Clearwater, FL 33765-3244
Phone (727) 303-3995

Other identifiers 1

IdentifierTypeStateIssuer
89136TYMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000273 FL Practitioner - Psychiatry 5890761019 Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME10342FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen D Howard MD LLC Psychiatry Past Accepting new patients
Appalachian Counseling,LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1861484677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S DUNCAN AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337566255",
            "telephone_number": "727-303-3995",
            "fax_number": "727-242-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S DUNCAN AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-303-3995",
            "fax_number": "727-242-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2189 Cleveland St",
            "address_2": "SUITE G207",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337653244",
            "country_code": "US",
            "telephone_number": "727-303-3995",
            "fax_number": "727-303-3995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "JOHN",
        "middle_name": "DUANE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME10342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136TY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.