Nicole Johnson

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

4225 E University Dr Apt 128
Mesa, AZ 85205-7092

Phone

(719) 321-5099

NPI assigned

Apr 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1457096885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 S GREENFIELD RD APT 1059",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063391",
            "telephone_number": "719-321-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 E UNIVERSITY DR APT 128",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057092",
            "telephone_number": "719-321-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "AZ",
            "license": "LIC23-07617",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Rose Johnson, PA-S
• Mary Z. Johnson, M.S., CCC-SPL
• Matthew Mark Johnson, MS, ATC, CSCS
• Melissa Lynn Johnson, DBH, MC, LPC
• Michael Lee Johnson, DDS
• Patricia J Johnson, RD
• Quarntal Johnson
• Rebecca Jo Johnson
• Sarah Morales Johnson
• Shari Kay Johnson, CCC SLP

• Adult Companion in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Adult Companion in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.