Individual provider Active NPI

Debra K Johnson

  • Registered Nurse First Assistant
  • Clinton, IA
National Provider Identifier
1336372978
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
058677 Issued in IA
Practice address
915 13TH Ave N
Clinton, IA 52732-5067
Phone
(563) 243-2511
Fax
(563) 243-0817
NPI assigned
Aug 31, 2009
Last updated
Mar 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 058677 IA Primary

Addresses

Primary practice location

915 13TH Ave N
Clinton, IA 52732-5067

Mailing address

915 13TH Ave N
Clinton, IA 52732-5067
Phone (563) 243-2511

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
058677IAMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1336372978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBRA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IA",
            "license": "058677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.