Georgette R Johnson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

120 Renaissance Cir Ste 1
Mauldin, SC 29662-2459

Phone

(864) 907-7627

NPI assigned

Feb 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1184488355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 REVIS CREEK CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816339",
            "telephone_number": "864-907-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RENAISSANCE CIR STE 1",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622459",
            "telephone_number": "864-907-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GEORGETTE",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "205384",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Stellfox Johnston, PHARMD, RPH
• Brienna Jamel Jones
• Zachary Jones
• Nomita Joshi, MD
• JTM Global Enterprises LLC

• In Home Supportive Care Agency in Mauldin, SC
• Providers in Mauldin, SC by specialty
• In Home Supportive Care Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.