DAN JOHNSON (NPI# 1720004716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720004716 |
| Entity Type | Individual |
| Full Name | DAN JOHNSON |
| Credential | PHD |
| Practice Address |
1201 Fleming Ave Jonesboro AR 72401 |
| Practice Telephone | 8709335174 |
| Practice Fax Number | 8709335235 |
| Mailing Telephone | 8709335174 |
| Mailing Fax Number | 8709335235 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 0110P | AR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | MEDICARE GROUP # | 5F374 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700269024 | Dan Johnson | Anesthesiologist Assistant | 1847 Summit Creek Way, Loganville, GA 30052-8875 | 2015-07-06 |
| 1154523843 | Dan Johnson | Social Worker | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2007-06-04 |
| Street Address |
1201 FLEMING AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619941556 | Cms Jonesboro Rehabilitation Inc | Rehabilitation Hospital | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2006-02-15 |
| 1417292608 | Encompass Health Rehabilitation Hospital of Jonesboro, LLC | Rehabilitation Hospital | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2012-11-29 |
| 1205104346 | Joe W Vincent | Pharmacist | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2011-12-04 |
| 1740579069 | Clinical Neuropsych, Pa | Community/Behavioral Health | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2011-04-07 |
| 1174661003 | Dan Johnson Phd Clinical Neuropsychologist,p.a. | Specialist | 1201 Fleming Ave, Jonesboro, AR 72401-4311 | 2007-02-02 |
| 1588683775 | Virendar Kumar Verma | Physical Medicine & Rehabilitation | 1201 Fleming Ave, Health South Rehablitation Hospital of Jonesboro, Jonesboro, AR 72403 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| 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 |
|---|---|---|---|---|
| 1841507894 | Kristin J Addison-brown | Clinical Neuropsychologist | 304 Southwest Sq, Jonesboro, AR 72401-5984 | 2010-09-10 |
| 1174826499 | Center for Pediatric Neuroscience, Pllc | Clinical Neuropsychologist | 2808 Fox Meadow Ln, Jonesboro, AR 72404-9346 | 2010-12-08 |
| 1235465733 | Julia Olivia Land | Clinical Neuropsychologist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2009-10-19 |
| 1871743328 | Emily Jo Anderson Mackillop | Clinical Neuropsychologist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2008-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902579 | Kaitlyn Marie Gall | Clinical Neuropsychologist | 6020 Warden Rd Ste 210, Sherwood, AR 72120-6015 | 2020-11-02 |
| 1033510037 | Seth T Sorensen | Clinical Neuropsychologist | 1 Childrens Way # 512-21, Little Rock, AR 72202 | 2014-09-09 |
| 1912205725 | Consulting Psychology of Western Arkansas, Inc. | Clinical Neuropsychologist | 1100 S Waldron Rd, Fort Smith, AR 72903-2552 | 2011-03-02 |
| 1851619613 | Neuropsychology Associates, P.a. | Clinical Neuropsychologist | 620 Dutton Mountain Rd, Center Ridge, AR 72027-8469 | 2010-05-04 |
| 1225367725 | Elizabeth Speck-kern | Clinical Neuropsychologist | 3 Innwood Cr., Ste 111, Little Rock, AR 72211 | 2009-12-11 |
| 1477785822 | Andrews Neuropsychology Consulting, Pplc | Clinical Neuropsychologist | 1701 Centerview Dr Ste 123, Little Rock, AR 72211-4311 | 2009-08-19 |
| 1851501803 | Garrett Andrews | Clinical Neuropsychologist | 2400 Riverfront Dr, Apt. 1437, Little Rock, AR 72202-2208 | 2007-05-22 |
| 1538215660 | Ronald Eugene Mcinroe | Clinical Neuropsychologist | 217 North East, Fayetteville, AR 72701 | 2007-01-25 |
| 1033285150 | William Austin Cochran IIi | Clinical Neuropsychologist | 287 Valley Club Cir, Little Rock, AR 72212-2934 | 2006-11-28 |
| 1740392919 | Jennifer Lewis Gess | Clinical Neuropsychologist | 4301 W Markham St # 554, Little Rock, AR 72205-7101 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
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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.