DR. JAMES (JIM) CHARLES JOHNSON (NPI# 1497831713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497831713 |
| Entity Type | Individual |
| Full Name | DR. JAMES (JIM) CHARLES JOHNSON |
| Other Name | DR. JIM JOHNSON |
| Credential | PH.D. |
| Practice Address |
516 Se 71st Ave Portland OR 97215-2132 |
| Practice Telephone | 5032523906 |
| Practice Fax Number | 5032525824 |
| Mailing Telephone | 5032523906 |
| Mailing Fax Number | 5032525824 |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 0515 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PSYCHOLOGY LICENSE NUMBER | 0515 | 01 |
| Street Address |
516 SE 71ST AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-2132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801098090 | Nancy Loss | Clinical Neuropsychologist | 2223 Ne 47th Avenue, Portland, OR 97213 | 2007-06-01 |
| 1346457017 | Mark Gregory Kiefner | Clinical Neuropsychologist | 26 Portland Street, Portland, ME 04101 | 2007-05-16 |
| 1184774937 | Melvyn E Attfield | Clinical Neuropsychologist | 225 Commercial Street, Suite #303, Portland, ME 04101 | 2007-01-12 |
| 1437215712 | Patrice Deidre Carrello | Clinical Neuropsychologist | 2354 Se 59th Ave, Portland, OR 97215-4018 | 2006-12-29 |
| 1386722247 | Donald Edward Lange | Clinical Neuropsychologist | 8040 Sw Capitol Hill Rd, Portland, OR 97219-2670 | 2006-11-01 |
| 1245327501 | Julia Ann Wong-ngan | Clinical Neuropsychologist | 205 Se Spokane St Ste 300, Portland, OR 97202-6487 | 2006-10-06 |
| 1295820389 | Nadia E. Webb | Clinical Neuropsychologist | 1631 Ne Broadway Street. No. 237, Portland, OR 97232 | 2006-10-04 |
| 1720094477 | Thomas G Miller | Clinical Neuropsychologist | 86 Dartmouth St, Portland, ME 04103-4808 | 2006-08-01 |
| 1811923246 | Dawn Wilkinson | Clinical Neuropsychologist | 458 N Broadway, Suite B, Portland, TN 37148-1767 | 2006-06-25 |
| 1043257058 | Richard Kolbell | Clinical Neuropsychologist | 1923 Ne Broadway, Portland, OR 97232-1501 | 2006-05-31 |
| Find all providers in PORTLAND | ||||
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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.