Individual provider Active NPI

Cheryl Denise Johnson, RPH

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1558947861
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
034727L Issued in PA
Practice address
5800 Ridge Avenue
Pharmacy-Basement
Philadelphia, PA 19128
Phone
(215) 487-4323
Fax
(215) 487-4352
NPI assigned
Mar 18, 2021
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 034727L PA Primary

Addresses

Primary practice location

5800 Ridge Avenue
Pharmacy-Basement
Philadelphia, PA 19128

Mailing address

2731 Poplar St
Philadelphia, PA 19130-1220
Phone (215) 805-3881

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
034727LPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1558947861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 POPLAR ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301220",
            "telephone_number": "215-805-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 RIDGE AVENUE",
            "address_2": "PHARMACY-BASEMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19128",
            "telephone_number": "215-487-4323",
            "fax_number": "215-487-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHERYL",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "034727L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.