Individual provider Active NPI

Lindsay Ann Johnson, PHARMD

  • Pharmacist
  • Shawnee, KS
National Provider Identifier
1629239298
Registry record updated Oct 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-100468 Issued in KS
Practice address
22700 W 55TH Ter
Shawnee, KS 66226-5602
Phone
(913) 422-1825
Fax
(913) 422-1079
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 1174 KS
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 1-100468 KS Primary

Addresses

Primary practice location

22700 W 55TH Ter
Shawnee, KS 66226-5602

Mailing address

22700 W 55TH Ter
Shawnee, KS 66226-5602
Phone (913) 422-1825

Other identifiers 2

IdentifierTypeStateIssuer
100098080COtherKSSED WAIVER
100098080AMedicaidKS

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
1174KSMDCognitive & Behavioral Psychologist
1-100468KSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665878400000",
    "number": "1629239298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22700 W 55TH TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662265602",
            "telephone_number": "913-422-1825",
            "fax_number": "913-422-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22700 W 55TH TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662265602",
            "telephone_number": "913-422-1825",
            "fax_number": "913-422-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LINDSAY",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2022-10-16",
        "certification_date": "2022-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "KS",
            "license": "1174",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-100468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SED WAIVER",
            "identifier": "100098080C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098080A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2022; 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.