Shaun Johnson

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Practice address

14 Ivanhoe PL
Valley Stream, NY 11580-2902

Phone

(917) 975-3906

NPI assigned

Apr 30, 2008

Sex

Male

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

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1427224369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 IVANHOE PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802902",
            "telephone_number": "917-975-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 IVANHOE PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802902",
            "telephone_number": "917-975-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Natasha Johnson, OTR/L
• Emma Christine Johnson
• Kippy Johnson
• Latasha Johnson
• Maria G Johnson, LCSW
• Tania Jones-Michael, LMSW
• Brenda Jones
• Diamond Jones, MSW
• Jamie Jones
• Jeremiah Jones, RN

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.