Individual provider Active NPI

Rachel L Wilson-Johnson

  • Other Technician
  • Summerville, SC
National Provider Identifier
1285305797
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
RBT-20-149545 Issued in SC
Practice address
120A E 5TH North St
Summerville, SC 29483-6822
Phone
(843) 934-1968
Fax
(888) 298-0519
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X RBT-20-149545 SC Primary

Addresses

Primary practice location

120A E 5TH North St
Summerville, SC 29483-6822

Mailing address

120A E 5TH North St
Summerville, SC 29483-6822
Phone (843) 934-1968

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
RBT-20-149545SCMDOther Technician

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1285305797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120A E 5TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836822",
            "telephone_number": "843-934-1968",
            "fax_number": "888-298-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120A E 5TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836822",
            "telephone_number": "843-934-1968",
            "fax_number": "888-298-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-JOHNSON",
        "first_name": "RACHEL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "SC",
            "license": "RBT-20-149545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.