Jacob Steven Samuel Johnson, RN

Primary specialty

Hospice Registered NurseTaxonomy code 163WH1000X

License

RN60479564 Issued in WA

Practice address

1313 Broadway Ste 200
Tacoma, WA 98402-3400

Phone

(206) 301-6400

NPI assigned

Jun 6, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1609617158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023400",
            "telephone_number": "206-301-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACOB",
        "middle_name": "STEVEN SAMUEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WA",
            "license": "RN60479564",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "WA",
            "license": "RN60479564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Johnson, LPN
• Heide A Johnson
• Heidi Kristine Johnson, L.M.P.
• Holly Johnson, LCSW
• Howard L. Johnson
• James Johnson, LICSW
• Jenna Angelina Johnson, LMT
• Jennifer A Johnson, LMT
• Jerome Johnson
• Joeseph Johnson, CADC

• Hospice Registered Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Hospice Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.