Phoebe Hannah Johnson-Black, MD

Primary specialty

Neurocritical Care PhysicianTaxonomy code 2084A2900X

License

A163477 Issued in CA

Practice address

757 Westwood PLZ Ste 6263
Los Angeles, CA 90095-1437

Phone

(310) 267-9448

NPI assigned

Apr 23, 2018

Last updated

Jul 18, 2022By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Regents of the University of California

  dba UCLA Neurology Group Practice

  • Neurology Physician
  • Los Angeles, CA
  • NPI 1437117074
  Medicare reassignment NPD
• The Regents of the University of California

  dba UCLA Neurology Group Practice

  • Neurology Physician
  • Santa Monica, CA
  • NPI 1114557295
  NPD
• The Regents of the University of California

  dba UCLA Neurology Group Practice

  • Land Ambulance
  • Los Angeles, CA
  • NPI 1962219410

  Neurocritical Care

  NPD

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1275021545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 6263",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951437",
            "telephone_number": "310-267-9448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14445 Olive View Dr Ste 2B-182",
            "address_purpose": "LOCATION",
            "city": "Sylmar",
            "state": "CA",
            "postal_code": "913421437",
            "country_code": "US",
            "telephone_number": "747-219-3205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON-BLACK",
        "first_name": "PHOEBE",
        "middle_name": "HANNAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A163477",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "CA",
            "license": "A163477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "39 STUDENT",
            "identifier": "390200000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashaad Shahib Johnson Charon, CMT
• Loraine Oweela Johnson Davis
• Deborah Jean Johnson Hayes, LCSW
• Fred Johnson Jr.
• Johnson Pharmacy Corp (L a Good Neighbor Pharmacy)
• Keena Johnson-Bolden, FNP-BC
• Ramona Lynn Johnson-Hackett, BS,RTC
• Natasha Johnson-Henderson
• Lajoi Johnson-Huff
• Latonia Johnson-Zachary

• Neurocritical Care Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurocritical Care Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.