Individual provider Active NPI

Angelique R Johnson, CNA

  • Nurse's Aide
  • Detroit, MI
National Provider Identifier
1356220552
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
0520202270630 Issued in MI
Practice address
20156 Picadilly Rd
Detroit, MI 48221-1310
Phone
(313) 460-9013
NPI assigned
Sep 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 0520202270630 MI Primary

Addresses

Primary practice location

20156 Picadilly Rd
Detroit, MI 48221-1310

Mailing address

20156 Picadilly Rd
Detroit, MI 48221-1310
Phone (313) 460-9013

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
0520202270630MIMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1356220552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20156 PICADILLY RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211310",
            "telephone_number": "313-460-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20156 PICADILLY RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211310",
            "telephone_number": "313-460-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELIQUE",
        "middle_name": "R",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-01",
        "last_updated": "2025-09-01",
        "certification_date": "2025-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MI",
            "license": "0520202270630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.