Active NPI
Elwaine Kendall Johnson
- Durable Medical Equipment & Medical Supplies
- Corinth, TX
National Provider Identifier
1447689906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 801870304
- Practice address
- 1402 N Corinth St
Suite 212B
Corinth, TX 76208-5445 - Phone
- (940) 489-1735
- NPI assigned
- Nov 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 801870304 | TX | Primary |
Addresses
Primary practice location
1402 N Corinth St
Suite 212B
Corinth, TX 76208-5445
Mailing address
1402 N Corinth St
Suite 212B
Corinth, TX 76208-5445
Phone (940) 489-1735
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
| License | State | Type | Specialty |
|---|---|---|---|
| 801870304 | TX | MD | Durable Medical Equipment & Medical Supplies |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1447689906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 N CORINTH ST",
"address_2": "SUITE 212B",
"city": "CORINTH",
"state": "TX",
"postal_code": "762085445",
"telephone_number": "940-489-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 N CORINTH ST",
"address_2": "SUITE 212B",
"city": "CORINTH",
"state": "TX",
"postal_code": "762085445",
"telephone_number": "940-489-1735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ELWAINE",
"middle_name": "KENDALL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": "801870304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corinth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.