Individual provider Active NPI

Rachel V Johnson, LVN

  • Licensed Vocational Nurse
  • Fort Worth, TX
National Provider Identifier
1609189851
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
335479 Issued in TX
Practice address
4829 Alicia Dr
Fort Worth, TX 76133-7401
Phone
(585) 224-6399
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 28633-1 NY
Licensed Vocational Nurse 164X00000X 335479 TX Primary

Addresses

Primary practice location

4829 Alicia Dr
Fort Worth, TX 76133-7401

Mailing address

4829 Alicia Dr
Fort Worth, TX 76133-7401
Phone (585) 224-6399

Other practice location 1

5000 E Henrietta Rd
Apt. E3
Henrietta, NY 14467-8926
Phone (585) 415-3697

Other practice location 2

228 Rock Meadow Dr
Crowley, TX 76036-3706
Phone (585) 456-5062

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

State licenses

LicenseStateTypeSpecialty
28633-1NYMDLicensed Practical Nurse
335479TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Stampleyshealthcaresolution Licensed Vocational Nurse Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1609189851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 ALICIA DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761337401",
            "telephone_number": "585-224-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 ALICIA DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761337401",
            "telephone_number": "585-224-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 E Henrietta Rd",
            "address_2": "Apt. E3",
            "address_purpose": "LOCATION",
            "city": "Henrietta",
            "state": "NY",
            "postal_code": "144678926",
            "country_code": "US",
            "telephone_number": "585-415-3697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "228 Rock Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Crowley",
            "state": "TX",
            "postal_code": "760363706",
            "country_code": "US",
            "telephone_number": "585-456-5062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RACHEL",
        "middle_name": "V",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "28633-1",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "335479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.