Damaris Johnson

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2018014785 Issued in MO

Practice address

4055 Valley View LN
Dallas, TX 75244-5074

Phone

(972) 715-3800

NPI assigned

Aug 27, 2018

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• NP Johnson Telehealth Wellness Care, LLC

  • Adult Health Nurse Practitioner
  • Lake Saint Louis, MO
  • NPI 1760201255
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1508347659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "972-715-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "972-715-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAMARIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2018014785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Ryan Johnson, PA
• Christyna Johnson, RDN
• Cynthia Johnson
• Dalton Johnson
• Dalwin Lee Johnson
• Danesha Johnson
• Danielle Johnson
• Danielle Nicole Johnson
• David Johnson, MD
• David Johnson, MD

• Primary Care Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.