John Joseph Popson III

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

2465578 Issued in OH

Practice address

1786 S Hickory Grove Rd
Port Clinton, OH 43452-9637

Phone

(419) 341-8753

NPI assigned

Oct 3, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1952025934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521332",
            "telephone_number": "419-341-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 S HICKORY GROVE RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434529637",
            "telephone_number": "419-341-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPSON",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "OH",
            "license": "2465578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyxandra Marie Perram
• Angela Petersen
• Derik Phillips
• Joshua Duepree Pitts, MS CDCA
• Elizabeth Ann Pollauf, RPH
• Port Clinton City
• Port Clinton City Schools
• Beth Eileen Powers
• Cheryl Pratt
• Panju Prithviraj, M.D.

• Supports Brokerage Agency in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Supports Brokerage Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.