Individual provider Active NPI

Karen R Johnson, PSY D

  • Clinical Psychologist
  • Birmingham, AL
National Provider Identifier
1871543223
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
486 Issued in AL
Practice address
2200 Lakeshore Drive
Suite 150
Birmingham, AL 35209
Phone
(205) 871-6926
Fax
(205) 871-7981
NPI assigned
May 10, 2006
Last updated
Nov 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 486 AL Primary

Addresses

Primary practice location

2200 Lakeshore Drive
Suite 150
Birmingham, AL 35209

Mailing address

2200 Lakeshore Drive
Suite 150
Birmingham, AL 35209
Phone (205) 871-6926

Other identifiers 1

IdentifierTypeStateIssuer
051031886OtherALBCBS OF AL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120125000794 AL Practitioner - Clinical Psychologist 0547437907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
486ALMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grayson and Associates PC Clinical CurrentSince Oct 7, 1996 Accepting new patients
SVPS Psychiatric Services LLC Past Accepting new patients

Locations

2200 Lakeshore Dr
Ste 150
Homewood, AL 35209
Phone (205) 397-4774

100 Concourse Pkwy
Ste 101
Hoover, AL 35244
Phone (205) 444-0420

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1871543223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LAKESHORE DRIVE",
            "address_2": "SUITE 150",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-871-6926",
            "fax_number": "205-871-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LAKESHORE DRIVE",
            "address_2": "SUITE 150",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-871-6926",
            "fax_number": "205-871-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAREN",
        "middle_name": "R",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "051031886",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.