Individual provider Active NPI

Deedee Ann Johnston

  • Pediatric Registered Nurse
  • Houston, TX
National Provider Identifier
1184218380
Registry record updated Feb 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
572384 Issued in TX
Practice address
2424 Wilcrest Dr
Houston, TX 77042-2761
Phone
(713) 666-8287
NPI assigned
Feb 28, 2021
Last updated
Feb 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 572384 TX Primary

Addresses

Primary practice location

2424 Wilcrest Dr
Houston, TX 77042-2761

Mailing address

34168 Haley Rd
Waller, TX 77484-4904
Phone (281) 794-1048

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL thrivespc.com Direct

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
572384TXMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1184218380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34168 HALEY RD",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774844904",
            "telephone_number": "281-794-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 WILCREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422761",
            "telephone_number": "713-666-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "DEEDEE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-28",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "572384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thrivespc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2424 Wilcrest Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770422761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.