Individual provider Active NPI

Gbenga Peter Johnson

  • Vehicle Modifications Contractor
  • Houston, TX
National Provider Identifier
1417675182
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vehicle Modifications ContractorTaxonomy code 171WV0202X
License
44582585 Issued in TX
Practice address
13811 Roman Ridge LN
Houston, TX 77047-1247
Phone
(832) 488-9109
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vehicle Modifications Contractor 171WV0202X 44582585 TX Primary

Addresses

Primary practice location

13811 Roman Ridge LN
Houston, TX 77047-1247

Mailing address

13811 Roman Ridge LN
Houston, TX 77047-1247
Phone (832) 488-9109

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
44582585TXMDVehicle Modifications Contractor

Practice roles

OrganizationSpecialtyStatusNew patients
Triune Global Services LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1417675182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13811 ROMAN RIDGE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471247",
            "telephone_number": "832-488-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13811 ROMAN RIDGE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471247",
            "telephone_number": "832-488-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GBENGA",
        "middle_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": "TX",
            "license": "44582585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.