Individual provider Active NPI

John Druilhett Johnston III, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1942469648
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17601 Issued in FL
Practice address
6326 Grand Oak Cir
Apt 104
Bradenton, FL 34203-7135
Phone
(207) 446-6123
NPI assigned
Jun 6, 2008
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC5946 ME
Clinical Social Worker 1041C0700X SW17601 FL Primary

Addresses

Primary practice location

6326 Grand Oak Cir
Apt 104
Bradenton, FL 34203-7135

Mailing address

6326 Grand Oak Cir
Apt 104
Bradenton, FL 34203-7135
Phone (207) 446-6123

Other identifiers 1

IdentifierTypeStateIssuer
223830099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050830000507 ME Practitioner - Clinical Social Worker 5496786303 Practice locations: Hallowell, ME
I20201112000157 FL Practitioner - Clinical Social Worker 5496786303 Reassigns benefits to 3 organizations
Practice locations: Bradenton, FL; St Petersburg, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6326 Grand Oak Cir
Apt 104
Bradenton, FL 34203-7135
Phone (207) 446-6123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC5946MEMDAddiction (Substance Use Disorder) Counselor
SW17601FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Mar 10, 2023 Accepting new patients
Mindful Mental Health Services - FL Gulf SW LLC Clinical CurrentSince Dec 22, 2021 Accepting new patients
Direct Access Counseling & Supportive Services, LLC Clinical CurrentSince Jun 18, 2021 Accepting new patients
Ultima Rehab-FL LLC PastSince May 29, 2019 Accepting new patients
Sweetser Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

8980 49th St N
Pinellas Park, FL 33782
Phone (727) 546-4053

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, 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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1942469648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 GRAND OAK CIR",
            "address_2": "APT 104",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342037135",
            "telephone_number": "207-446-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 GRAND OAK CIR",
            "address_2": "APT 104",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342037135",
            "telephone_number": "207-446-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JOHN",
        "middle_name": "DRUILHETT",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5946",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223830099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.