Fannie Shariee Johnson, MEDICAL ASISSITANT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0021128 Issued in CO

Practice address

19549 Randolph PL
Denver, CO 80249-8609

Phone

(720) 209-8897

NPI assigned

Jun 20, 2008

Last updated

Apr 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• My Healing Space Counseling PLLC

  • Mental Health Counselor
  • Aurora, CO
  • NPI 1215862404

  Addiction (Substance Use Disorder)

  NPD Authorized official
• My Healing Space Counseling PLLC

  • Specialist
  • Denver, CO
  • NPI 1235824582

  Addiction (Substance Use Disorder)

  NPD Authorized official
• My Healing Space Counseling PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Aurora, CO
  • NPI 1508618455

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1245491422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19549 RANDOLPH PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802498609",
            "telephone_number": "720-209-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19549 RANDOLPH PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802498609",
            "telephone_number": "720-209-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "FANNIE",
        "middle_name": "SHARIEE",
        "credential": "MEDICAL ASISSITANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0021128",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CO",
            "license": "0335945",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Ross Johnson, RN
• Erica Lee Johnson
• Erik C Johnson, PHARMD
• Erin Johnson, MSW, LSW, MFTC
• Erin Marie Johnson, RN
• Gabriele Elizabeth Johnson, CCC-SLP
• Gregory Johnson, NP
• Hannah Johnson, LCSW
• Heather Emily Johnson, MD
• Hunter Johnson

• Addiction (Substance Use Disorder) Counselor in Denver, CO
• Providers in Denver, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.