Individual provider Active NPI

Tamara Johnson

  • Licensed Practical Nurse
  • Savannah, GA
National Provider Identifier
1033575865
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN067622 Issued in GA
Practice address
515 E 63Rd St
Savannah, GA 31405-4300
Phone
(912) 355-5938
Fax
(912) 352-0802
NPI assigned
Jan 8, 2016
Last updated
Jan 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN067622 GA Primary

Addresses

Primary practice location

515 E 63Rd St
Savannah, GA 31405-4300

Mailing address

515 E 63Rd St
Savannah, GA 31405-4300
Phone (191) 235-5593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN067622GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1033575865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E 63RD ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054300",
            "telephone_number": "191-235-5593",
            "fax_number": "912-352-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E 63RD ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054300",
            "telephone_number": "912-355-5938",
            "fax_number": "912-352-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN067622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.