Mary Ann Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN0046296 Issued in CO

Practice address

3524 Airfield Rd
Fort Carson, CO 80913-4701

Phone

(719) 524-6627

Fax

(719) 524-6621

NPI assigned

Feb 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1346832128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 VALLEY VIEW DR",
            "city": "DIVIDE",
            "state": "CO",
            "postal_code": "808149127",
            "telephone_number": "719-367-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 AIRFIELD RD",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134701",
            "telephone_number": "719-524-6627",
            "fax_number": "719-524-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CO",
            "license": "PN0046296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA COLORADO",
            "identifier": "PN0046296",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.a.johnson472.civ@mail.mil",
            "affiliation": "N",
            "address_1": "3524 Airfield Rd",
            "city": "Fort Carson",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809134701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karsten G Jennings, D.O.
• Steven Jewett, O.D.
• Theodore Jimenez, LPN
• Allison Elaine Johnson
• James Robert Johnson Jr., DPM
• Nicole Johnson, M.D.
• Renee Johnson, RN
• Rufus Lee Johnson Jr.
• Shirley Ann Johnson, CNM
• Teresa Kay Johnson, RDH

• Licensed Practical Nurse in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Licensed Practical Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.