Krystal Michele Johnson

Primary specialty

ContractorTaxonomy code 171W00000X

License

5681890001 Issued in MI

Practice address

31 Oakland Ave
Suite 1B
Pontiac, MI 48342-2019

Phone

(248) 758-9813

Fax

(248) 758-9815

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Johnsons Medical Supply LLC

  • Customized Equipment (DME)
  • Pontiac, MI
  • NPI 1720102072
  NPD (past) Authorized official
• Johnsons Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, MI
  • NPI 1932157443
  NPD (past) Authorized official
• At Home Chore Services, LLC

  • In Home Supportive Care Agency
  • Pontiac, MI
  • NPI 1629852405
  NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063536571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OAKLAND AVE",
            "address_2": "SUITE 1B",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422019",
            "telephone_number": "248-758-9813",
            "fax_number": "248-758-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OAKLAND AVE",
            "address_2": "SUITE 1B",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422019",
            "telephone_number": "248-758-9813",
            "fax_number": "248-758-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRYSTAL",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MI",
            "license": "5681890001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4641944",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erinn Martine Johnson, LMSW
• Floretta Johnson, LMSW
• Jasmine Jamila Johnson, DPT
• Jenetta Johnson, LLMSW-CLINICAL
• Jill Kathleen Johnson, DNAP, CRNA
• Melissa Johnson, NP
• Paul Christopher Johnson, MD
• Ravon Johnson
• Rhonda Johnson
• Roslyn Marie Johnson, LLMSW

• Contractor in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.