Deshah Jalen Johnson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5021005 Issued in NC

Practice address

833 Wake Forest Business Park Ste F
Wake Forest, NC 27587-7184

Phone

(919) 230-1419

NPI assigned

Oct 12, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clemons Resiliency & Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wake Forest, NC
  • NPI 1407623549
  NPD
• Greene Mental Wellness, PLLC

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Wake Forest, NC
  • NPI 1093456378
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1013737212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK AT NORTH HILLS ST APT 1208",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276092651",
            "telephone_number": "910-554-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 WAKE FOREST BUSINESS PARK STE F",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877184",
            "telephone_number": "919-230-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DESHAH",
        "middle_name": "JALEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-12",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021005",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5021005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jess Beu Integrative Therapy
• Joanna Gamble DMD, PLLC
• John F. Kubiak, LMFT, PLLC
• Wendell Clavonn John, RN, MSN, FNP-C
• Amanda Steele Johnson, OD
• Sarah Ann Johnson, LMFTA
• Tiara Jalynn Johnson, RPH
• Elizabeth Barnes Jolley, PHD CCC-SLP
• Renee Stein Jolly, MS, CCC-SLP
• Cree Jones

• Psychiatric/Mental Health Nurse Practitioner in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.