Ilyasah Q Johnson, CNA,PBT

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

5460-23 Issued in NJ

Practice address

115 Philadelphia Ave
Ste B #224
Egg Harbor City, NJ 08215-1200

Phone

(856) 202-6243

NPI assigned

Jan 16, 2025

Reactivated

Jan 27, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Laboratory Excellence Concierge Services LLC

  dba Laboratory Excellence Concierge Services

  • Phlebotomy Technician
  • Egg Harbor City, NJ
  • NPI 1437960549

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1326859570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 E WALNUT RD APT 38",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605040",
            "telephone_number": "609-405-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PHILADELPHIA AVE",
            "address_2": "STE B #224",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082151200",
            "telephone_number": "856-202-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ILYASAH",
        "middle_name": "Q",
        "credential": "CNA,PBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-16",
        "deactivation_date": "2025-01-16",
        "reactivation_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "NJ",
            "license": "NA200036261",
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NJ",
            "license": "5460-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hands-on Plus Spine & Orthopedic Physical Therapy
• Matthew Hanley, PSYD
• Hendricks House, Inc. (Hansen House)
• Kerry B Hunter, OTR/L
• Jersey Speech LLC
• Sam Jonuzi
• Valbona Jonuzi, LCSW
• Michael Allen Joyce, RN
• Joseph Salvatore Kember, PT
• Molly Kley

• Phlebotomy Technician in Egg Harbor City, NJ
• Providers in Egg Harbor City, NJ by specialty
• Phlebotomy Technician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.