Individual provider Active NPI

Thomaisina Johnson, LIFE COACH/CLERGY

  • Pastoral Counselor
  • Shillington, PA
National Provider Identifier
1538826219
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Practice address
18 Philadelphia Ave Apt 4
Shillington, PA 19607-2798
Phone
(484) 540-0851
NPI assigned
Nov 17, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X PA
Home Health Aide 374U00000X PA
Pastoral Counselor 101YP1600X Primary

Addresses

Primary practice location

18 Philadelphia Ave Apt 4
Shillington, PA 19607-2798

Mailing address

18 Philadelphia Ave Apt 4
Shillington, PA 19607-2798
Phone (484) 540-0851

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Shillington Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aicm LLC CurrentSince Dec 5, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1538826219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PHILADELPHIA AVE APT 4",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072798",
            "telephone_number": "484-540-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PHILADELPHIA AVE APT 4",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072798",
            "telephone_number": "484-540-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAISINA",
        "credential": "LIFE COACH/CLERGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Shillington",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18 Philadelphia Ave Apt 4",
            "city": "Shillington",
            "state": "PA",
            "country_code": "US",
            "postal_code": "196072798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shillington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.