CARL EUGENE JOHNSON III (NPI# 1104424183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104424183 |
Entity Type | Individual |
Full Name | CARL EUGENE JOHNSON III |
Credential | PSS |
Practice Address |
125 S Main Cross St Louisa KY 41230-1065 |
Practice Telephone | 6066390938 |
Practice Fax Number | 8598135394 |
Mailing Telephone | 6066390938 |
Mailing Fax Number | 8598135394 |
Enumeration Date | 2020-10-13 |
Last Update Date | 2020-10-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720362288 | Carl Johnson | Contractor | 101 S 12th St, Mcalester, OK 74501-5656 | 2011-10-03 |
1356572440 | Carl Edward Johnson | Social Worker | 1537 W Adams St, #2r, Chicago, IL 60607-2451 | 2009-08-06 |
1083878490 | Carl R Johnson | Pharmacist | 524 Dean Hall Ct, Mt Pleasant, SC 29464-6204 | 2008-07-15 |
1205044369 | Carl Joseph Johnson | Dentist | 7241 Owensmouth Ave, Canoga Park, CA 91303-1530 | 2007-05-20 |
1700908670 | Carl Allen Johnson | Dermatology | 2610 Blossom St, Columbia, SC 29205-2308 | 2007-04-04 |
1427183847 | Carl Frederick Johnson | Marriage & Family Therapist | 2200 Century Parkway, Suite 200, Atlanta, GA 30345-3103 | 2007-02-23 |
1912063652 | Carl Austin Johnson | Physical Therapist | 285 W Francis, Blackfoot Physical Therapy, Blackfoot, ID 83221 | 2006-12-28 |
1437264033 | Carl L Johnson | Internal Medicine | 5320 W 12th St, Little Rock, AR 72204 | 2006-08-21 |
1144237215 | Carl E Johnson | Internal Medicine | 87 Herrick St, Beverly, MA 01915-2773 | 2006-08-02 |
1487679684 | Carl E Johnson | Pathology | 24 Las Praderas Dr, San Luis Obispo, CA 93401-7410 | 2006-07-12 |
Street Address |
125 S MAIN CROSS ST |
City | LOUISA |
State | KY |
Zip Code | 41230-1065 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154415594 | Amanda Slone | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2006-10-02 |
1124629282 | Brittany Baker | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-11-05 |
1750981296 | Ashlee Nicole Clemmons | Registered Nurse | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-26 |
1740889526 | Timothy Carter | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-22 |
1447858428 | Nancy Lynn Pelfrey | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-13 |
1497352983 | Aquarius Dion Young | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-07 |
1760089254 | John Kevin Schmidt Jr. | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-07 |
1841897519 | Patrick Michael Fogarty | Counselor | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-10-06 |
1942817622 | Seth Patrick Myers | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-09-28 |
1154936250 | Dustin Hiram Cornett | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-09-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811533599 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 105-107 E Madison St., Louisa, KY 41230 | 2019-11-18 |
1780236570 | Addiction Recovery Care LLC | Substance Abuse Rehabilitation Facility | 1640 Jerushia Branch Rd., Booneville, KY 41230 | 2019-07-11 |
1922528272 | Samantha Paige Stanley | Peer Specialist | 221 Windy Hill Drive, Louisa, KY 41230 | 2017-06-27 |
1407393457 | Chandra D Blevins | Peer Specialist | 125 N. Main Cross St., Louisa Office Addiction Recovery Care, Louisa, KY 41230 | 2017-01-30 |
1033654876 | Amanda Hurley | Peer Specialist | 125 N. Main Cross Street, Louisa, KY 41230 | 2017-01-04 |
1780127753 | Dakota Williams | Peer Specialist | 125 N Cross Main St, Louisa, KY 41230 | 2016-11-23 |
1568905529 | Tara Runyon | Peer Specialist | 125 N Main Cross Street, Louisa, KY 41230 | 2016-11-23 |
1134575624 | Misty Howell I | Peer Specialist | 125 S. Main Cross Street, Louisa, KY 41230 | 2016-05-13 |
1720404478 | Louisa Dental Care | Dentist | 203 S. Water St, Louisa, KY 41230 | 2014-03-05 |
1326336728 | Elite Chiropractic Psc | Chiropractor | 4347 Highway 2565, Louisa, KY 41230 | 2011-07-19 |
Find all providers in zip 41230 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548861842 | Odell Levi Dixon | Peer Specialist | 105 S Main Cross St, Louisa, KY 40517 | 2020-11-03 |
1922528272 | Samantha Paige Stanley | Peer Specialist | 221 Windy Hill Drive, Louisa, KY 41230 | 2017-06-27 |
1407393457 | Chandra D Blevins | Peer Specialist | 125 N. Main Cross St., Louisa Office Addiction Recovery Care, Louisa, KY 41230 | 2017-01-30 |
1033654876 | Amanda Hurley | Peer Specialist | 125 N. Main Cross Street, Louisa, KY 41230 | 2017-01-04 |
1780127753 | Dakota Williams | Peer Specialist | 125 N Cross Main St, Louisa, KY 41230 | 2016-11-23 |
1568905529 | Tara Runyon | Peer Specialist | 125 N Main Cross Street, Louisa, KY 41230 | 2016-11-23 |
1518313014 | Latasha Leighann Byrd | Peer Specialist | 3651 Us Highway 2565, Louisa, KY 41320 | 2016-05-13 |
1134575624 | Misty Howell I | Peer Specialist | 125 S. Main Cross Street, Louisa, KY 41230 | 2016-05-13 |
1942655766 | Ashlea Leslie | Peer Specialist | 3651 Highway 2565, Louisa, KY 41230-5018 | 2016-04-29 |
1225483019 | Sara Young I | Peer Specialist | 2135 Highway 1185, Louisa, KY 41230-7968 | 2016-04-28 |
Find all providers in LOUISA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.