MATTHEW DAVID JOHNSON (NPI# 1649345208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649345208 |
| Entity Type | Individual |
| Full Name | MATTHEW DAVID JOHNSON |
| Credential | PHD |
| Practice Address |
240 Riverside Dr Ste 2 Johnson City NY 13790-2732 |
| Practice Telephone | 6077971652 |
| Practice Fax Number | 6077976631 |
| Mailing Telephone | 6077971652 |
| Mailing Fax Number | 6077976631 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
014850 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MVP INSURANCE | 418400 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336706514 | Matthew Thomas Johnson | Counselor | 4643 American Legion Rd Se, Iowa City, IA 52240-9057 | 2019-05-23 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1023523016 | Matthew Johnson | Specialist/Technologist | 51 Armstrong Rd, Enfield, CT 06082-2731 | 2017-12-12 |
| 1881105914 | Matthew Alan Johnson | Optometrist | 360 Merrimack St Bldg 91, Lawrence, MA 01843-1740 | 2017-10-16 |
| 1801324991 | Matthew Allen Johnson | Psychologist | 1812 Sumner Ave Ste 1, Aberdeen, WA 98520-4602 | 2017-06-01 |
| 1306377288 | Matthew Johnson | Specialist/Technologist | 713 Mill Grove Dr, Audubon, PA 19403 | 2017-03-23 |
| 1386026003 | Matthew Johnson | Dentist | 72 Ashe St Apt A, Charleston, SC 29403-5964 | 2015-06-18 |
| 1992183057 | Matthew Johnson | Specialist/Technologist | 18220 San Lucas Ct, Brookfield, WI 53045-3870 | 2015-05-11 |
| 1487058582 | Matthew John Johnson | Specialist/Technologist | 27 Whittier Dr, Greenlawn, NY 11740-2609 | 2014-10-17 |
| 1265845945 | Matthew Johnson | Behavioral Analyst | 504 S Hays Ave Apt 5, Carbondale, IL 62901-2631 | 2014-06-10 |
| Street Address |
240 RIVERSIDE DR STE 2 |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1548692692 | Jason Lee Steadman | Psychologist | 1193 Jack Vest Dr, Behavioral Health and Wellness Clinic, Johnson City, TN 37614-6505 | 2013-07-31 |
| 1588670210 | Stephen L. Owens | Psychologist | 302 Sunset Dr Ste 106, Johnson City, TN 37604-2408 | 2006-08-01 |
| 1467476150 | Tedd A Stephens | Psychologist | 2112 N Roan St Fl 6, Johnson City, TN 37601-2519 | 2006-07-26 |
| 1790717411 | Nancy L Lanthorn | Psychologist | 704 E Watauga Ave, Johnson City, TN 37601-4112 | 2006-07-06 |
| 1811960644 | Kerry L. Holland | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2006-02-10 |
| 1760464937 | Heather L Beaudry | Psychologist | 1907 N Roan St Ste 207, Johnson City, TN 37601-3182 | 2005-11-15 |
| 1770197766 | Mary Ann Moore | Psychologist | 679 Main St, Johnson City, NY 13790-1716 | 2020-09-07 |
| 1184232605 | Bess Summerlin Lewis | Psychologist | Lamont St & Veterans Way, Johnson City, TN 37604 | 2020-07-21 |
| 1245856566 | Meredith K Ginley | Psychologist | 166 Derosier Dr, Johnson City, TN 37614-5200 | 2020-06-23 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
Please comment or provide details below to improve the information on MATTHEW DAVID JOHNSON.
| 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.