Active NPI
Neysa L. Johnson, M.D.
- Psychiatry Physician
- Southlake, TX
National Provider Identifier
1881797702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M0770
- Practice address
- 305 Miron Dr
Southlake, TX 76092-7831 - Phone
- (817) 479-9363
- Fax
- (817) 479-9363
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M0770 | TX | Primary |
Addresses
Primary practice location
305 Miron Dr
Southlake, TX 76092-7831
Mailing address
305 Miron Dr
Southlake, TX 76092-7831
Phone (214) 663-1172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 6, 2018 through Nov 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M0770 | TX | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pecan Valley MHMR Region | Psychiatry | Past | Accepting new patients |
| Lubbock Regional MHMR Center | Psychiatry | Past | Accepting new patients |
| Bluebonnet Trails Community MHMR Center | Psychiatry | Past | Accepting new patients |
| Pecan Valley MHMR Region | Past | Accepting new patients | |
| West Texas Centers for MHMR | Psychiatry | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Round Rock, TX
- NPI 1730135864
Psychiatry
-
- Primary Care Nurse Practitioner
- Cleburne, TX
- NPI 1285342295
-
- Psychiatry Physician
- Big Spring, TX
- NPI 1154348514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1881797702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 MIRON DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927831",
"telephone_number": "214-663-1172",
"fax_number": "817-479-9363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 MIRON DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927831",
"telephone_number": "817-479-9363",
"fax_number": "817-479-9363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "NEYSA",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "M0770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.