Individual provider Active NPI

Elton Edward Johnson Jr., APRN

  • Licensed Vocational Nurse
  • Honolulu, HI
National Provider Identifier
1508844861
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
69774 Issued in TX
Practice address
400 Sand Island Pkwy
Uscg
Honolulu, HI 96819-4326
Phone
(808) 842-2930
Fax
(808) 832-3281
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 583059 TX
Ambulatory Care Registered Nurse 163WP2201X 45098 HI
Licensed Vocational Nurse 164X00000X 69774 TX Primary
Family Nurse Practitioner 363LF0000X 675 HI

Addresses

Primary practice location

400 Sand Island Pkwy
Uscg
Honolulu, HI 96819-4326

Mailing address

98-139 Kanuku St
Apt 109
Aiea, HI 96701-5123
Phone (808) 488-1237

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

State licenses

LicenseStateTypeSpecialty
69774TXMDProfessional Counselor
675HIMDPsychologist
583059TXMDGeneral Practice Registered Nurse
45098HIMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508844861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-139 KANUKU ST",
            "address_2": "APT 109",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015123",
            "telephone_number": "808-488-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SAND ISLAND PKWY",
            "address_2": "USCG",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968194326",
            "telephone_number": "808-842-2930",
            "fax_number": "808-832-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELTON",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "583059",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "HI",
            "license": "45098",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "69774",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.