Individual provider Active NPI

Andreale Hyman'Johnson, LPN

  • Licensed Practical Nurse
  • Hudson, NY
National Provider Identifier
1114686938
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
310541 Issued in NY
Practice address
300 Town Hall Dr Apt C4
Hudson, NY 12534-1228
Phone
(518) 929-3872
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 310542 NY
Licensed Practical Nurse 164W00000X 310541 NY Primary

Addresses

Primary practice location

300 Town Hall Dr Apt C4
Hudson, NY 12534-1228

Mailing address

300 Town Hall Dr Apt C4
Hudson, NY 12534-1228
Phone (518) 929-3872

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
310541NYMDLicensed Practical Nurse
310542NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1114686938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWN HALL DR APT C4",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125341228",
            "telephone_number": "518-929-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWN HALL DR APT C4",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125341228",
            "telephone_number": "518-929-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYMAN'JOHNSON",
        "first_name": "ANDREALE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "310542",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "310541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.