Keondra C Johnson

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Practice address

2140 Medical District Dr Apt 2052
Dallas, TX 75235-8097

Phone

(214) 695-4955

NPI assigned

Sep 22, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1578179750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 HIGHWAY 287 N STE 106",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632643",
            "telephone_number": "214-695-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 MEDICAL DISTRICT DR APT 2052",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358097",
            "telephone_number": "214-695-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEONDRA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A. Johnson, MD
• Kendra Johnson
• Kendrick C Johnson, CRNA
• Kenneth B Johnson, MD
• Kenneth R Johnson
• Kerry R Johnson, M.D.
• Keshaun Antoinette Johnson
• Kevin Russell Johnson, PA-C
• Kevin Wayne Johnson, CRNA
• Kiana Johnson, CHW

• Intellectual Disabilities Intermediate Care Facility in Dallas, TX
• Providers in Dallas, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.

Verify at the official NPI Registry.