Individual provider Active NPI

Grant Edward Johnson

  • Non-emergency Medical Transport (VAN)
  • Gibsland, LA
National Provider Identifier
1225451370
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
41235361K Issued in LA
Practice address
1221 Hilltop St
Gibsland, LA 71028
Phone
(318) 843-6090
Fax
(318) 843-6090
NPI assigned
Jan 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 008591754 LA
Non-emergency Medical Transport (VAN) 343900000X 41235361K LA Primary

Addresses

Primary practice location

1221 Hilltop St
Gibsland, LA 71028

Mailing address

P O Box 423
1221 Hilltop St
Gibsland, LA 71028
Phone (318) 843-6090

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
008591754LAMDDriver
41235361KLAMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1225451370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 423",
            "address_2": "1221 HILLTOP ST",
            "city": "GIBSLAND",
            "state": "LA",
            "postal_code": "71028",
            "telephone_number": "318-843-6090",
            "fax_number": "318-843-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 HILLTOP ST",
            "city": "GIBSLAND",
            "state": "LA",
            "postal_code": "71028",
            "telephone_number": "318-843-6090",
            "fax_number": "318-843-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GRANT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "LA",
            "license": "008591754",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "LA",
            "license": "41235361K",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsland, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.