Active NPI
Keri Ann Johnson
- General Practice Registered Nurse
- Ruskin, FL
National Provider Identifier
1164229092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- RN9417442
- Practice address
- 9813 Ivory Dr
Ruskin, FL 33573-6795 - Phone
- (636) 614-9581
- NPI assigned
- Feb 27, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | RN9417442 | FL | Primary |
Addresses
Primary practice location
9813 Ivory Dr
Ruskin, FL 33573-6795
Mailing address
2300 Windy Ridge Pkwy SE
Ste 850S
Atlanta, GA 30339
Phone (929) 376-0056
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN9417442 | FL | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740614400000",
"number": "1164229092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 WINDY RIDGE PKWY SE",
"address_2": "STE 850S",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30339",
"telephone_number": "929-376-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9813 IVORY DR",
"city": "RUSKIN",
"state": "FL",
"postal_code": "335736795",
"telephone_number": "636-614-9581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KERI",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-27",
"last_updated": "2025-02-27",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "FL",
"license": "RN9417442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruskin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.