Individual provider Active NPI

Toccara Johnson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, GA
National Provider Identifier
1093127250
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
236011 Issued in GA
Practice address
1826 Veterans Blvd
Dublin, GA 31021-3620
Phone
(478) 272-1210
Fax
(478) 274-5625
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 236011 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 236011 GA Primary

Addresses

Primary practice location

1826 Veterans Blvd
Dublin, GA 31021-3620

Mailing address

7324 Quail Run Rd
Lizella, GA 31052-3758
Phone (478) 321-4698

Other practice location 1

7324 Quail Run Rd
Lizella, GA 31052-3758
Phone (478) 321-4698

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
236011GAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1093127250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 QUAIL RUN RD",
            "city": "LIZELLA",
            "state": "GA",
            "postal_code": "310523758",
            "telephone_number": "478-321-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 VETERANS BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213620",
            "telephone_number": "478-272-1210",
            "fax_number": "478-274-5625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7324 Quail Run Rd",
            "address_purpose": "LOCATION",
            "city": "Lizella",
            "state": "GA",
            "postal_code": "310523758",
            "country_code": "US",
            "telephone_number": "478-321-4698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TOCCARA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "236011",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "236011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.