Chaderick Demond Johnson

Primary specialty

Chronic Care Clinical Nurse SpecialistTaxonomy code 364SC2300X

License

910440 Issued in VA

Practice address

747 Piney Forest Rd
Danville, VA 24540-2860

Phone

(434) 429-8848

Fax

(434) 549-9051

NPI assigned

Sep 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1104547538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402860",
            "telephone_number": "434-429-8848",
            "fax_number": "434-549-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402860",
            "telephone_number": "434-429-8848",
            "fax_number": "434-549-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHADERICK",
        "middle_name": "DEMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC2300X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "VA",
            "license": "910440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "hitemhard03@gmail.com",
            "affiliation": "N",
            "address_1": "747 Piney Forest Rd",
            "city": "Danville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245402860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jesserwallddspa
• John Stephen Eggleston, D.C., P.C.
• John T. Will, DDS, PLLC
• Johnnys Heroes Youth and Family Services, Inc.
• Cassandra Lynn Johnson, LCSW
• Christina Johnson, M.A. , LMHP-S
• Deja Andreya Johnson, PHARM.D
• Demetria Johnson
• Geoffrey Edward Johnson, D.D.S.
• Robert Johnson

• Clinical Nurse Specialist in Danville, VA
• Providers in Danville, VA by specialty
• Clinical Nurse Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.