DR. JOURDAN JOHNSON – Marriage & Family Therapist, NPI 1871086140

DR. JOURDAN JOHNSON is a healthcare provider. based in Salt lake city, Utah. specializing in MARRIAGE AND FAMILY THERAPIST. The NPI Number for DR. JOURDAN JOHNSON is 1871086140

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOURDAN JOHNSON
NPI
1871086140
Phone
Not provided
Address
4190 S HIGHLAND DR STE 113
Enumeration Date
12 June 2018
Last Update Date
24 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012652000
Graduation Year
2023 (3 years ago)
PAC ID
0244675734
Group Practice PAC ID
7719882562
Professional Enrollment ID
I20240223001825
Address ID
UT841241371SA1250X3900301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:7State licenses:0Digital endpointsOther names

148 MARRIAGE AND FAMILY THERAPIST in UT

Provider Addresses for DR. JOURDAN JOHNSON

  • 4190 S HIGHLAND DR STE 113

    SALT LAKE CITY, UT 841242673

    Phone:

    Type: Mailing

  • 300, San Leandro Boulevard, San Leandro, Alameda County, California, 94577, United States

    SAN LEANDRO, CA 945771675

    Phone: (916) 690-0399

    Type: Location

  • 811 GRAND AVE

    SACRAMENTO, CA 958383466

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240223001825IMarriage And Family TherapistUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719882562View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. JOURDAN JOHNSON using NPI 1871086140?
NPI 1871086140 belongs to DR. JOURDAN JOHNSON; compare other details if you need extra assurance.
Active or inactive — what applies to DR. JOURDAN JOHNSON?
You should see DR. JOURDAN JOHNSON as active in CMS-hosted NPPES data.
What area of care is associated with DR. JOURDAN JOHNSON?
DR. JOURDAN JOHNSON's record emphasizes Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Is DR. JOURDAN JOHNSON associated with Salt Lake City?
Public fields place DR. JOURDAN JOHNSON around Salt Lake City, Utah. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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