Individual provider Active NPI

Bridget Danene Johnson, LPN

  • Licensed Practical Nurse
  • Euclid, OH
National Provider Identifier
1235647090
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN110583 Issued in OH
Practice address
1545 E 254TH St
Euclid, OH 44117-1201
Phone
(216) 712-3929
NPI assigned
Jan 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN110583 OH Primary

Addresses

Primary practice location

1545 E 254TH St
Euclid, OH 44117-1201

Mailing address

1545 E 254TH St
Euclid, OH 44117-1201
Phone (216) 712-3929

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
PN110583OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1235647090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 E 254TH ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171201",
            "telephone_number": "216-712-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E 254TH ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171201",
            "telephone_number": "216-712-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIDGET",
        "middle_name": "DANENE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN110583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.

Verify at the official NPI Registry.