Demarco Shauntez Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

279 Summit Dr
Waterford, MI 48328-3364

Phone

(248) 745-4900

NPI assigned

Apr 19, 2024

Last updated

Apr 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1609621085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17499 W 13 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761266",
            "telephone_number": "131-352-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUMMIT DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283364",
            "telephone_number": "248-745-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEMARCO",
        "middle_name": "SHAUNTEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Jerome
• Kimbery Ann Jezierski
• John a Lazarus DDS Ms PC
• John P Quarton PC
• Bryan J Johnson, D.D.S.
• Derra Johnson
• Djanae Johnson
• Jayci Johnson, FNP
• Marion B. Johnson, SOCIAL WORKER
• Mark Johnson

• Case Manager/Care Coordinator in Waterford, MI
• Providers in Waterford, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.