Individual provider Active NPI

Bobby Cordell Johns Jr., LCDCI

  • Addiction (Substance Use Disorder) Counselor
  • Austin, TX
National Provider Identifier
1922818830
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
61122 Issued in TX
Practice address
8500 Shoal Creek Blvd Ste 114
Austin, TX 78757-7591
Phone
(512) 763-2565
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 61122 TX Primary

Addresses

Primary practice location

8500 Shoal Creek Blvd Ste 114
Austin, TX 78757-7591

Mailing address

208 Grasslands TRL
Hutto, TX 78634-2172
Phone (512) 629-8326

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

State licenses

LicenseStateTypeSpecialty
61122TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1922818830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 GRASSLANDS TRL",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786342172",
            "telephone_number": "512-629-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 SHOAL CREEK BLVD STE 114",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577591",
            "telephone_number": "512-763-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "BOBBY",
        "middle_name": "CORDELL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCDCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "61122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.