Jimmy Wallace Johnson Jr.

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

706 Pennick Rd
Brunswick, GA 31525-5310

Phone

(912) 275-7889

NPI assigned

Jul 29, 2018

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": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532822400000",
    "number": "1447738893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 PENNICK RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315255310",
            "telephone_number": "912-275-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 PENNICK RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315255310",
            "telephone_number": "912-275-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JIMMY",
        "middle_name": "WALLACE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-29",
        "last_updated": "2018-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John F. Ellenberg, M.D., P.C.
• John K Weaver, DMD PC
• Chadrika L Johnson, OWNER, CENTER DIRECT
• Deborah F Johnson, RN-BSN
• Evelyn Delois Johnson, M.D.
• Laura Johnson, PA-C
• Mallory Harris Johnson, CRNA
• Mark Robin Johnson, DDS
• Steven G Johnson, M.D.
• Tawana Johnson, RN

• Home Health Aide in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Home Health Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2018; 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.