Individual provider Active NPI

Tzipora S Johnson, RNFA

  • Registered Nurse First Assistant
  • Jacksonville, FL
National Provider Identifier
1497809644
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN1979802 Issued in FL
Practice address
10278 Wellhouse CT
Jacksonville, FL 32220-1351
Phone
(954) 383-5742
Fax
(904) 786-1164
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN1979802 FL Primary

Addresses

Primary practice location

10278 Wellhouse CT
Jacksonville, FL 32220-1351

Mailing address

10278 Wellhouse CT
Jacksonville, FL 32220-1351
Phone (954) 383-5742

Other identifiers 1

IdentifierTypeStateIssuer
015887300MedicaidFL

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1497809644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10278 WELLHOUSE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322201351",
            "telephone_number": "954-383-5742",
            "fax_number": "904-786-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10278 WELLHOUSE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322201351",
            "telephone_number": "954-383-5742",
            "fax_number": "904-786-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TZIPORA",
        "middle_name": "S",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "RN1979802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015887300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.