Gloria Omar Johnson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002023000 Issued in VA

Practice address

4926 W Broad St
Richmond, VA 23230-3122

Phone

(804) 673-5241

NPI assigned

Aug 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1114692159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 MILTON ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232222843",
            "telephone_number": "804-241-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4926 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303122",
            "telephone_number": "804-673-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLORIA",
        "middle_name": "OMAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002023000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Johnson, LPC
• Dove-Anna Johnson
• Ebony Johnson
• Emily Z Johnson, SLP
• Evette Johnson, FNP
• Grace Johnson
• Granville Woodworth Johnson, D.D.S.
• Jacqueline Deborah Johnson I
• Jade Johnson
• Jane Johnson, PT

• Licensed Practical Nurse in Richmond, VA
• Providers in Richmond, VA by specialty
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.