Andrea Viretta Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703054592 Issued in MI

Practice address

13340 E Warren Ave
Detroit, MI 48215-2112

Phone

(313) 822-6940

Fax

(313) 822-6946

NPI assigned

Oct 7, 2008

Last updated

Oct 7, 2008By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Positive Images

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1255410023
  NPD (past)
• Positive Images

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1407079882
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1083865208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13340 E. WARREN AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48215",
            "telephone_number": "313-822-6940",
            "fax_number": "313-822-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13340 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152112",
            "telephone_number": "313-822-6940",
            "fax_number": "313-822-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "middle_name": "VIRETTA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703054592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Ursula Johnson, NP
• Amanda C Johnson, M.A., CLA, CHW
• Amina Johnson, LLMSW
• Andrea Johnson
• Andrea Antoinette Johnson
• Andrew Johnson III, RN
• Angela Johnson
• Angelique R Johnson, CNA
• Antwone Johnson Sr., LPN
• Aquirry Johnson

• Licensed Practical Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.