Individual provider Active NPI

Pamela Ann Johnson, REGISTERED NURSE

  • Case Manager/Care Coordinator
  • South Charleston, WV
National Provider Identifier
1609481258
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
37438 Issued in WV
Practice address
325 4TH Ave Ste 4
South Charleston, WV 25303-1266
Phone
(304) 744-4940
Fax
(304) 746-5620
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 37438 WV Primary

Addresses

Primary practice location

325 4TH Ave Ste 4
South Charleston, WV 25303-1266

Mailing address

PO Box 123
Handley, WV 25102-0123
Phone (304) 442-8155

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
37438WVMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
A Special Touch for Seniors, LLC PastSince Sep 13, 2020 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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1609481258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "HANDLEY",
            "state": "WV",
            "postal_code": "251020123",
            "telephone_number": "304-442-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 4TH AVE STE 4",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031266",
            "telephone_number": "304-744-4940",
            "fax_number": "304-746-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WV",
            "license": "37438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.