Active NPI
Ellie Johnson
- Social Worker
- Mountain BRK, AL
National Provider Identifier
1962107557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3736 Montrose Rd
Mountain BRK, AL 35213-3832 - Phone
- (205) 871-3583
- NPI assigned
- Apr 3, 2023
- Last updated
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | NU | Primary |
Addresses
Primary practice location
3736 Montrose Rd
Mountain BRK, AL 35213-3832
Mailing address
PO Box 5474
Maryville, TN 37802-5474
Phone (865) 661-4787
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": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1962107557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5474",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378025474",
"telephone_number": "865-661-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3736 MONTROSE RD",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352133832",
"telephone_number": "205-871-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ELLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.