Individual provider Active NPI

Martin Daniel Johnson

  • Intellectual & Developmental Disabilities Psychologist
  • Asheville, NC
National Provider Identifier
1881736023
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
23 Beaver Valley Rd
Asheville, NC 28804-1802
Phone
(828) 254-4032
Fax
(828) 254-4032
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

23 Beaver Valley Rd
Asheville, NC 28804-1802

Mailing address

23 Beaver Valley Rd
Asheville, NC 28804-1802
Phone (828) 254-4032

Other identifiers 1

IdentifierTypeStateIssuer
3409307MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881736023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BEAVER VALLEY RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288041802",
            "telephone_number": "828-254-4032",
            "fax_number": "828-254-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BEAVER VALLEY RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288041802",
            "telephone_number": "828-254-4032",
            "fax_number": "828-254-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARTIN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409307",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.