Individual provider Active NPI

Hiram Johnson

  • Contractor
  • Sparks, NV
National Provider Identifier
1356636716
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
6504 Citori Dr
Sparks, NV 89436-7392
Phone
(775) 354-0657
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

6504 Citori Dr
Sparks, NV 89436-7392

Mailing address

6504 Citori Dr
Sparks, NV 89436-7392
Phone (775) 354-0657

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2011.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1356636716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 CITORI DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367392",
            "telephone_number": "775-354-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 CITORI DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367392",
            "telephone_number": "775-354-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HIRAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.