Individual provider Active NPI

Robert Howard Johnson Jr., N.P.

  • Family Nurse Practitioner
  • Saint Joseph, MO
National Provider Identifier
1427486190
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN081322 Issued in GA
Practice address
5325 Faraon St
Saint Joseph, MO 64506
Phone
(816) 271-7273
Fax
(816) 271-7376
NPI assigned
Oct 16, 2013
Last updated
Nov 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN081322 GA Primary
Family Nurse Practitioner 363LF0000X 23819 CA
Family Nurse Practitioner 363LF0000X 2018012958 MO

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506

Mailing address

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-7273

Other practice location 1

105 Far West Dr Ste 202
Saint Joseph, MO 64506-3514
Phone (816) 271-8133

Other practice location 2

340 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

Other identifiers 2

IdentifierTypeStateIssuer
23819OtherCANURSE PRACTITIONER LICENSE
RN081322OtherGANURSE PRACTITIONER LICENSE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018012958MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1427486190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Far West Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063514",
            "country_code": "US",
            "telephone_number": "816-271-8133",
            "fax_number": "816-271-8134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173838",
            "country_code": "US",
            "telephone_number": "478-765-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "HOWARD",
        "name_suffix": "Jr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN081322",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23819",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018012958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "23819",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "RN081322",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.