Patrice Lanae Johnson, RPH, PMP

Primary specialty

PharmacistTaxonomy code 183500000X

License

051-039374 Issued in IL

Practice address

13601 Kenton Ave
Crestwood, IL 60418-1938

Phone

(708) 926-7270

Fax

(855) 793-8197

NPI assigned

Mar 3, 2021

Sex

Female

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

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

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.

• Medication Management Partners

  • Long Term Care Pharmacy
  • Crestwood, IL
  • NPI 1740512094
  NPD

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1497340236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 KENTON AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604181938",
            "telephone_number": "708-926-7270",
            "fax_number": "855-793-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 KENTON AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604181938",
            "telephone_number": "708-926-7270",
            "fax_number": "855-793-8197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 S Harding Ave",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051439",
            "country_code": "US",
            "telephone_number": "708-261-4980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICE",
        "middle_name": "LANAE",
        "credential": "RPH, PMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-039374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumaieh Jaber, COTA/L
• JBMV Health Associates, LLC
• Arthur Felipe Jimenez, MS, MA, BCBA, LPC
• Cierra D Johnson, PA-C
• Ebony Nicole Johnson, MD
• Kelly Jean Jordan
• Thomas I Joseph, MD
• Sejal Kalawadia, MD
• Theresa A Kasick
• Joseph H Kent, MD

• Pharmacist in Crestwood, IL
• Providers in Crestwood, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.