Vonda Johnson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

224856 Issued in NY

Practice address

1156 Cook Street
Clinton Correctional Facility
Dannemora, NY 12929

Phone

(518) 492-2511

NPI assigned

Dec 30, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of New York

  • Institutional Pharmacy
  • Dannemora, NY
  • NPI 1053713883
  NPD (past)
• State of New York Office of State Comptroller

  • Pharmacy
  • Dannemora, NY
  • NPI 1982589636
  NPD (past)

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1376908640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "DANNEMORA",
            "state": "NY",
            "postal_code": "129292000",
            "telephone_number": "518-492-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 COOK STREET",
            "address_2": "CLINTON CORRECTIONAL FACILITY",
            "city": "DANNEMORA",
            "state": "NY",
            "postal_code": "12929",
            "telephone_number": "518-492-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VONDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Bouvier Barnes
• Jeannette G. Bingel
• Gabrielle Clark
• Susan V. Devlin-Varin, FNP-C
• Amie Lynn Eggleston
• Donna Jeanne Larocque, FNP
• Maggy Pharmacy Inc
• Leo E Maggy, R.PH
• Mark Kennedy Maggy, R.PH
• Matthew Kennedy Maggy, PHARMD

• All providers in Dannemora, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.