Active NPI
Tajuana Johnson, APN
- Family Nurse Practitioner
- Lisle, IL
National Provider Identifier
1588969166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209008594
- Practice address
- 805 Ogden Ave
Lisle, IL 60532-1337 - Phone
- (331) 903-1759
- Fax
- (708) 398-6870
- NPI assigned
- Jan 13, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209008594 | IL | Primary |
Addresses
Primary practice location
805 Ogden Ave
Lisle, IL 60532-1337
Mailing address
161 Washington Street, 14TH Floor
Eight Tower Bridge, Suite 1400
Conshohocken, PA 19428
Phone (866) 825-3227
Other practice location 1
3401 W Roosevelt Rd
Chicago, IL 60624
Phone (866) 825-3227
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tjohnson237371@direct.edward.org |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glow Health and Wellness Medical Spa, PC | Current | Accepting new patients |
Interoperability endpoints
- tjohnson237371@direct.edward.org
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 and National Provider Directory roles.
-
- Clinic/Center
- Chicago, IL
- NPI 1205345337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1588969166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 WASHINGTON STREET, 14TH FLOOR",
"address_2": "EIGHT TOWER BRIDGE, SUITE 1400",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "19428",
"telephone_number": "866-825-3227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 OGDEN AVE",
"city": "LISLE",
"state": "IL",
"postal_code": "605321337",
"telephone_number": "331-903-1759",
"fax_number": "708-398-6870"
}
],
"practiceLocations": [
{
"address_1": "3401 W Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60624",
"country_code": "US",
"telephone_number": "866-825-3227",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "TAJUANA",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-13",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209008594",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tjohnson237371@direct.edward.org",
"affiliation": "N",
"address_1": "805 Ogden Ave",
"city": "Lisle",
"state": "IL",
"country_code": "US",
"postal_code": "605321337",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lisle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.