Individual provider Active NPI

Gara Maxine Johnson, R.N.

  • Registered Nurse
  • Homewood, AL
National Provider Identifier
1508006008
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-043680 Issued in AL
Practice address
234 Goodwin Crest Dr
Homewood, AL 35209-3701
Phone
(205) 290-4599
Fax
(205) 290-4560
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-043680 AL Primary

Addresses

Primary practice location

234 Goodwin Crest Dr
Homewood, AL 35209-3701

Mailing address

PO Box 19848
Birmingham, AL 35219-0848
Phone (205) 290-4599

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-043680ALMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1508006008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19848",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352190848",
            "telephone_number": "205-290-4599",
            "fax_number": "205-290-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODWIN CREST DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352093701",
            "telephone_number": "205-290-4599",
            "fax_number": "205-290-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARA",
        "middle_name": "MAXINE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-043680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.