Active NPI
Jovan Johnson
- Personal Care Attendant
- Las Vegas, NV
National Provider Identifier
1356997274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 6615 S Eastern Ave
Las Vegas, NV 89119-3921 - Phone
- (702) 722-6200
- Fax
- (702) 722-6202
- NPI assigned
- Aug 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
6615 S Eastern Ave
Las Vegas, NV 89119-3921
Mailing address
420 Wonderstone Dr
Las Vegas, NV 89107-2831
Phone (702) 371-4412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251E00000X | Other | NV | HOME HEALTH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1356997274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 WONDERSTONE DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891072831",
"telephone_number": "702-371-4412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 S EASTERN AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891193921",
"telephone_number": "702-722-6200",
"fax_number": "702-722-6202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOVAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-15",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME HEALTH",
"identifier": "251E00000X",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.