Annemarie Johnson

Key facts

NPI

1003360868

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

0145 (SD)

Practice address

10303 Quaal Rd
Black Hawk, SD 57718-9343

Phone

(605) 787-5798

NPI assigned

Aug 10, 2016

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 10, 2016.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1003360868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10303 QUAAL RD",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577189343",
            "telephone_number": "605-787-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10303 QUAAL RD",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577189343",
            "telephone_number": "605-787-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNEMARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "0145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Black Hawk, SD · Occupational Therapist in South Dakota