Active NPI
Claudette Elizabeth Johnson
- Contractor
- Maricopa, AZ
National Provider Identifier
1174031884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 8723402
- Practice address
- 21181 N Grantham Rd
Maricopa, AZ 85138-6655 - Phone
- (719) 464-9552
- NPI assigned
- Jan 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 8723402 | AZ | Primary |
Addresses
Primary practice location
21181 N Grantham Rd
Maricopa, AZ 85138-6655
Mailing address
21181 N Grantham Rd
Maricopa, AZ 85138-6655
Phone (719) 464-9552
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 |
|---|---|---|---|
| 8723402 | AZ | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516060800000",
"number": "1174031884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21181 N GRANTHAM RD",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851386655",
"telephone_number": "719-464-9552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21181 N GRANTHAM RD",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851386655",
"telephone_number": "719-464-9552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CLAUDETTE",
"middle_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-16",
"last_updated": "2018-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AZ",
"license": "8723402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maricopa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.