Scott Johnson, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

653-1 W 8TH St FL 4
Jacksonville, FL 32209-6511

Phone

(904) 244-3140

NPI assigned

Dec 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: sjohnson581430@direct.shands.ufl.edu

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1356000780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RIVERSIDE AVE UNIT 641",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024962",
            "telephone_number": "602-515-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653-1 W 8TH ST FL 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11567 Canterwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983325812",
            "country_code": "US",
            "telephone_number": "253-530-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-13",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Johnson, DDS
• Sandra Dee Johnson, MHSC, CTP
• Sandra Stark Johnson
• Sandra Y Johnson
• Savanna Johnson
• Shanice Johnson
• Shannon Johnson, M.S
• Shatavier Johnson
• Sherika Regina Johnson
• Sheryl Johnson, LMHC MCAP MAC

• Student in an Organized Health Care Education/Training Program in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.