Active NPI
Malinda Dawn Johnson
- Homemaker
- Middlebourne, WV
National Provider Identifier
1063018554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 504 Cherry St
Middlebourne, WV 26149-9618 - Phone
- (304) 758-4919
- Fax
- (304) 758-4680
- NPI assigned
- Dec 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
504 Cherry St
Middlebourne, WV 26149-9618
Mailing address
PO Box 68
Middlebourne, WV 26149-0068
Phone (304) 758-4919
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Council of Senior Tyler Countians, Inc. | Past | Accepting new patients | |
| Council of Senior Tyler Countians, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- In Home Supportive Care Agency
- Middlebourne, WV
- NPI 1295151207
-
- Nursing Care Agency
- Middlebourne, WV
- NPI 1891977575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1063018554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 68",
"city": "MIDDLEBOURNE",
"state": "WV",
"postal_code": "261490068",
"telephone_number": "304-758-4919",
"fax_number": "304-758-4680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 CHERRY ST",
"city": "MIDDLEBOURNE",
"state": "WV",
"postal_code": "261499618",
"telephone_number": "304-758-4919",
"fax_number": "304-758-4680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MALINDA",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-09",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlebourne, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.