Active NPI
Michael Lewis Johnson
- Social Worker
- Fort Myers, FL
National Provider Identifier
1114354354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 2789 Ortiz Ave
Fort Myers, FL 33905-7806 - Phone
- (239) 791-1586
- NPI assigned
- Oct 2, 2013
- Last updated
- Oct 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | NU | Primary |
Addresses
Primary practice location
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Mailing address
3736 Evans Ave
Fort Myers, FL 33901
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J525552903890 | Other | FL | DRIVER'S LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1114354354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3736 EVANS AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2789 ORTIZ AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057806",
"telephone_number": "239-791-1586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHAEL",
"middle_name": "LEWIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-02",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "J525552903890",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.