Individual provider Active NPI

Shakisha Johnson

  • Foster Care Agency
  • Tallahassee, FL
National Provider Identifier
1114470077
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
100057522 Issued in FL
Practice address
1882 Capital Cir NE
Ste 105
Tallahassee, FL 32308-4530
Phone
(850) 656-2320
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 100057522 FL Primary

Addresses

Primary practice location

1882 Capital Cir NE
Ste 105
Tallahassee, FL 32308-4530

Mailing address

1882 Capital Cir NE
Ste 105
Tallahassee, FL 32308-4530
Phone (850) 656-2320

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
100057522FLMDFoster Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1114470077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1882 CAPITAL CIR NE",
            "address_2": "STE 105",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084530",
            "telephone_number": "850-656-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1882 CAPITAL CIR NE",
            "address_2": "STE 105",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084530",
            "telephone_number": "850-656-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAKISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "FL",
            "license": "100057522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.