Gladys Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

CBHCM.0105662 Issued in FL

Practice address

4024 Central Ave
Saint Petersburg, FL 33711-1239

Phone

(727) 327-7656

NPI assigned

May 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Suncoast Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
  • NPI 1659371763
  NPD (past)

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1336839083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337330970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111239",
            "telephone_number": "727-327-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLADYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM.0105662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "suncoastcenter.org",
            "affiliation": "N",
            "address_1": "4024 Central Ave",
            "city": "Saint Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337111239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darien Malik James Johnson
• David Carl Johnson, DDS
• David Porter Johnson, M.D.
• Denise Johnson, RN
• Felicia L Johnson
• Holly D Johnson, ITDS
• Jason Leonard Johnson, DO
• Jayne Anne Johnson, LCSW
• Jeffery Lee Johnson, MD
• Jillian Leigh Johnson, D.C

• Case Manager/Care Coordinator in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.