Individual provider Active NPI

Melissa Jang Johnson

  • Pharmacist
  • Lakewood Ranch, FL
National Provider Identifier
1326438789
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6159933 Issued in FL
Practice address
11270 Ranch Creek Ter Apt 412
Lakewood Ranch, FL 34211-4040
Phone
(763) 213-7822
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6159933 FL Primary

Addresses

Primary practice location

11270 Ranch Creek Ter Apt 412
Lakewood Ranch, FL 34211-4040

Mailing address

11270 Ranch Creek Ter Apt 412
Lakewood Ranch, FL 34211-4040
Phone (763) 213-7822

Other identifiers 1

IdentifierTypeStateIssuer
PSI 32653OtherFLFLORIDA DEPARTMENT OF HEALTH

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
6159933FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1326438789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11270 RANCH CREEK TER APT 412",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342114040",
            "telephone_number": "763-213-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11270 RANCH CREEK TER APT 412",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342114040",
            "telephone_number": "763-213-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "JANG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "6159933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PSI 32653",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.