NPIMap

Individual provider Active NPI

Eric Marshall Johnson, PT TECH

  • Basic Emergency Medical Technician
  • Fort Rucker, AL
National Provider Identifier
1124396619
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
B1948957 Issued in TX
Practice address
Lyster Army Health Clinic
BLDG 301
Fort Rucker, AL 36362-5333
Phone
(334) 255-7169
Fax
(334) 255-7368
NPI assigned
Dec 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X B1948957 TX Primary

Addresses

Primary practice location

Lyster Army Health Clinic
BLDG 301
Fort Rucker, AL 36362-5333

Mailing address

Lyster Army Health Clinic
BLDG 301
Fort Rucker, AL 36362-5333
Phone (334) 255-7169

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
B1948957TXMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1124396619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LYSTER ARMY HEALTH CLINIC",
            "address_2": "BLDG 301",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7169",
            "fax_number": "334-255-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LYSTER ARMY HEALTH CLINIC",
            "address_2": "BLDG 301",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7169",
            "fax_number": "334-255-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "MARSHALL",
        "credential": "PT TECH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "TX",
            "license": "B1948957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.