Nicole Renee Johnson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG60971822 Issued in WA

Practice address

1338 Commerce Ave Ste 303
Longview, WA 98632-3726

Phone

(360) 261-6930

NPI assigned

May 31, 2019

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Community Integrated Health Services, LLC

  • Community/Behavioral Health Agency
  • Centralia, WA
  • NPI 1942840160

  Peer Specialist

  NPD (past)
• Peacehealth

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  NPD (past)

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1407414709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320378",
            "telephone_number": "360-261-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 COMMERCE AVE STE 303",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323726",
            "telephone_number": "360-261-6930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 Commerce Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986323726",
            "country_code": "US",
            "telephone_number": "360-261-6930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG60971822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Johnson
• Misty Dawn Johnson, LMP
• Nancy Johnson, MSCCCSLP
• Nasanya Johnson
• Nathan Mark Johnson, PHARM.D.
• Pyper Johnson
• Rachel L Johnson, SUDPT
• Reid Johnson, CCC-SLP
• Shirley Mae Johnson, P.T.
• Tammy L Johnson, OPTICIAN

• Peer Specialist in Longview, WA
• Providers in Longview, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.