Bonita D Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18176 Issued in SC

Practice address

241 Kelley St
Lake City, SC 29560-2446

Phone

(843) 394-1051

Fax

(843) 394-0277

NPI assigned

May 21, 2013

Last updated

Jun 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1508202359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 KELLEY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602446",
            "telephone_number": "843-394-1051",
            "fax_number": "843-394-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BONITA",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jackson Jr., PTA
• Paul Wells James, DNP
• Kirby Rebekah Jeffords
• Carlon Darneil Jenkins, NP
• Sheriko Jernigan
• Chrisshawn-Da Johnson
• Caitlin Altman Jordan, PA-C
• Chucky Sentell Jordan, D.C.
• Jan Downer Kight
• Pamela Horton Kirby, RPH

• Family Nurse Practitioner in Lake City, SC
• Providers in Lake City, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.