Deirdre Johnson, MAT LAT ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1975 Issued in NC

Practice address

5500 Dixon Dr
Raleigh, NC 27609-4202

Phone

(919) 881-4800

NPI assigned

Mar 8, 2014

Sex

Female

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

State licenses

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

{
    "created_epoch": "1394236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394236800000",
    "number": "1619393188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 VILLAGE GROVE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276133656",
            "telephone_number": "919-320-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 DIXON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094202",
            "telephone_number": "919-881-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEIRDRE",
        "credential": "MAT LAT ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-08",
        "last_updated": "2014-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "1975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curisa Rhadgim Ida Johnson
• Dana Michelle Johnson, NP
• Dana W Johnson, PA-C
• Danah Watkins Johnson, LPN
• Darnell Johnson, LCAS, LPCA
• Doneicia Rachelle Johnson, LCSWA
• Elena Eloise Johnson, MA, LCMHC, LCAS
• Elizabeth Johnson
• Elizabeth Johnson, DO
• Elizabeth Baynes Johnson, LCMHC-A

• Athletic Trainer in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2014; 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.