Individual provider Active NPI

Cassandra Alaine Johnson, LPN

  • Licensed Practical Nurse
  • Eugene, OR
National Provider Identifier
1114456084
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201407303LPN Issued in OR
Practice address
1166 E 28TH Ave
Eugene, OR 97403-1615
Phone
(541) 345-0534
Fax
(541) 345-8886
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201407303LPN OR Primary

Addresses

Primary practice location

1166 E 28TH Ave
Eugene, OR 97403-1615

Mailing address

3230 Pheasant Blvd
Springfield, OR 97477-7539
Phone (541) 852-6898

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
201407303LPNORMDLicensed Practical Nurse

Interoperability endpoints

  • Direct secure messaging: cassandra.johnson.p2@direct.lanecounty.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1114456084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 PHEASANT BLVD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974777539",
            "telephone_number": "541-852-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 E 28TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031615",
            "telephone_number": "541-345-0534",
            "fax_number": "541-345-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CASSANDRA",
        "middle_name": "ALAINE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201407303LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.