Individual provider Active NPI

Matthew David Johnson, A.P.

  • Acupuncturist
  • Winter Park, FL
National Provider Identifier
1962708495
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP 2933 Issued in FL
Practice address
1201 Louisiana Ave
Suite E
Winter Park, FL 32789-2340
Phone
(407) 644-2990
Fax
(407) 644-4370
NPI assigned
Jan 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP 2933 FL Primary

Addresses

Primary practice location

1201 Louisiana Ave
Suite E
Winter Park, FL 32789-2340

Mailing address

8091 Maritime Flag St
9101
Windermere, FL 34786-5575
Phone (407) 217-2609

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
AP 2933FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Family Healthcare PA Acupuncturist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1962708495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8091 MARITIME FLAG ST",
            "address_2": "9101",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347865575",
            "telephone_number": "407-217-2609",
            "fax_number": "407-644-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 LOUISIANA AVE",
            "address_2": "SUITE E",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892340",
            "telephone_number": "407-644-2990",
            "fax_number": "407-644-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "A.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP 2933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.