Marie Johnson

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

364 Neola St
Park Forest, IL 60466-2334

Phone

(708) 362-8960

NPI assigned

Mar 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Our Bags of Love Foundation

  • Public Health or Welfare Agency
  • Park Forest, IL
  • NPI 1245097609
  NPD Authorized official
• Mission Driven Transportation Inc

  • Transportation Broker
  • Country Club Hills, IL
  • NPI 1821562463
  NPD

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1467219683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 NEOLA ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662334",
            "telephone_number": "708-362-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 NEOLA ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662334",
            "telephone_number": "708-362-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jelani Helathcare and Family Services
• Andrene Renee Johnson
• Demitris Johnson
• Frankie Johnson
• Iesha J Johnson
• Matthew Todd Johnson, MD
• Kristen Jones
• Shukria Judon, DT
• James Arthur Kapost, LPC
• Amanda Kendrick, LPC

• Driver in Park Forest, IL
• Providers in Park Forest, IL by specialty
• Driver in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.