Active NPI
Victoria Mae Johnson
- Developmental Disabilities Clinic/Center
- North Miami Beach, FL
National Provider Identifier
1528690658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- Practice address
- 400 NE 177TH St
North Miami Beach, FL 33162-1914 - Phone
- (786) 423-7033
- NPI assigned
- Feb 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | Primary |
Addresses
Primary practice location
400 NE 177TH St
North Miami Beach, FL 33162-1914
Mailing address
400 NE 177TH St
North Miami Beach, FL 33162-1914
Phone (786) 423-7033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7636 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580947200000",
"number": "1528690658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 NE 177TH ST",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331621914",
"telephone_number": "786-423-7033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 NE 177TH ST",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331621914",
"telephone_number": "786-423-7033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "VICTORIA",
"middle_name": "MAE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-06",
"last_updated": "2020-02-06",
"certification_date": "2020-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7636",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.