MR. MATTHEW TRUMAN JOHNSON (NPI# 1932534260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932534260 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW TRUMAN JOHNSON |
| Practice Address |
2860 E 19500 N Moroni UT 84646 |
| Mailing Address |
480 E 100 S Ephraim UT 84627-5550 |
| Practice Telephone | 4354369029 |
| Mailing Telephone | 4358991624 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | UT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1235458555 | 05 |
| 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 |
2860 E 19500 N |
| City | MORONI |
| State | UT |
| Zip Code | 84646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750740668 | Tyler Olds | Counselor | 2860 E 19500 N, Moroni, UT 84646-0461 | 2016-02-19 |
| 1194190355 | Kevin Wilkey | Counselor | 2860 E 19500 N, Moroni, UT 84646-0461 | 2015-12-14 |
| 1346615507 | Brent Taylor | Counselor | 2860 E 19500 N, Moroni, UT 84646-0461 | 2015-12-14 |
| 1396110615 | Tyler Whittaker | Counselor | 2860 E 19500 N, Moroni, UT 84646 | 2015-12-11 |
| 1043639156 | Nathan Miner | Counselor | 2860 E 19500 N, Moroni, UT 84646-0461 | 2014-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942727029 | Doug Lloyd Hopes | Counselor | 21630 North 1450 East, Morona, UT 84646 | 2017-08-29 |
| 1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
| 1457611766 | Samuel Paul Wilkey | Substance Abuse Rehabilitation Facility | 21360 N 1450e, Moroni, UT 84646 | 2012-05-21 |
| 1275828949 | Robert Duane Simonson | Social Worker | 4800 East 17160 North, Moroni, UT 84646 | 2011-06-10 |
| 1386950392 | Josh Wilkey | Community Health Worker | 4800 E. 17160 N, Moroni, UT 84646 | 2010-08-27 |
| 1891007886 | Compass Academy | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E. 17160 N., Moroni, UT 84646 | 2010-07-08 |
| 1518906320 | Eileen Keenan Jackson | Family Medicine | 51 E Main St., Moroni, UT 84646 | 2006-06-06 |
| 1225537707 | Jessica Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| 1134628613 | Todd Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| 1386182426 | Richard Newton | Social Worker | 21260 N 1450 E, Moroni, UT 84646 | 2017-02-09 |
| Find all providers in zip 84646 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336556638 | Bryan Holder | Substance Abuse Rehabilitation Facility | 21360 N 1460 E, Moroni, UT 84646-0461 | 2014-07-18 |
| 1457611766 | Samuel Paul Wilkey | Substance Abuse Rehabilitation Facility | 21360 N 1450e, Moroni, UT 84646 | 2012-05-21 |
| 1235458555 | Lighthouse Ranch LLC | Substance Abuse Rehabilitation Facility | 21360 North 1450 East, Moroni, UT 84646-0461 | 2010-05-26 |
| 1447579115 | Lighthouse Academy LLC | Substance Abuse Rehabilitation Facility | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2010-05-20 |
| 1316314081 | Ethan Colburn | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646-0461 | 2015-08-28 |
| 1336523695 | Blue Hills Residential Treatment | Substance Abuse Rehabilitation Facility | 2860 East 19500 North, Moroni, UT 84646-0461 | 2015-07-16 |
| 1770960411 | Blue Hills Residential Treatment | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646-0461 | 2015-05-01 |
| 1720465727 | Blue Hills Residential Treatment | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646-0461 | 2015-04-29 |
| 1629497458 | James Beasley | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646 | 2014-04-09 |
| 1932460102 | Bryant Davis | Substance Abuse Rehabilitation Facility | 21360 North 1450 East, Moroni, UT 84646 | 2012-06-05 |
| Find all providers in MORONI | ||||
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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.