Individual provider Active NPI

Lakeshia Johnson

  • Behavior Technician
  • Jacksonville, FL
National Provider Identifier
1164067435
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2425 Dunn Ave Ste 2
Jacksonville, FL 32218
Phone
(904) 420-2304
Fax
(904) 508-0173
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2425 Dunn Ave Ste 2
Jacksonville, FL 32218

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580

Other practice location 1

300 Olive St
Green Cove Springs, FL 32043-2610
Phone (904) 235-7710

Other practice location 2

300 Olive St
Green Cove Springs, FL 32043-2610
Phone (904) 235-7710

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

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1164067435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "866-610-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DUNN AVE STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-420-2304",
            "fax_number": "904-508-0173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Olive St",
            "address_purpose": "LOCATION",
            "city": "Green Cove Springs",
            "state": "FL",
            "postal_code": "320432610",
            "country_code": "US",
            "telephone_number": "904-235-7710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Olive St",
            "address_purpose": "LOCATION",
            "city": "Green Cove Springs",
            "state": "FL",
            "postal_code": "320432610",
            "country_code": "US",
            "telephone_number": "904-235-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAKESHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.