Sandra Y Johnson

Primary specialty

SpecialistTaxonomy code 174400000X

License

NH2114 Issued in FL

Practice address

1800 Edgewood Ave, West #164
Jacksonville, FL 32208-5928

Phone

(904) 318-7993

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1083836852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 EDGEWOOD AVE W APT 164",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322088004",
            "telephone_number": "904-318-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 EDGEWOOD AVE, WEST #164",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085928",
            "telephone_number": "904-318-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SANDRA",
        "middle_name": "Y",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "NH2114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Mary Johnson, D.D.S.
• Royneisha Johnson, LMFT
• Ryan Johnson, DDS
• Sandra Dee Johnson, MHSC, CTP
• Sandra Stark Johnson
• Savanna Johnson
• Scott Johnson, DO
• Shanice Johnson
• Shannon Johnson, M.S
• Shatavier Johnson

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.