NPIMap

Organization Active NPI

Jeremiah Johnson

  • Licensed Practical Nurse
  • Milwaukee, WI
National Provider Identifier
1639401755
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
311777-031 Issued in WI
Legal business name
JEREMIAH JOHNSON
Practice address
3035 W Wisconsin Ave Apt 205
Milwaukee, WI 53208-3987
Phone
(414) 429-7880
NPI assigned
Feb 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Mr. Jeremiah Alan Johnson
Title
Licensed Practical Nurse
Phone
(414) 429-7880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 311777-031 WI Primary

Addresses

Primary practice location

3035 W Wisconsin Ave Apt 205
Milwaukee, WI 53208-3987

Mailing address

3035 W Wisconsin Ave Apt 205
Milwaukee, WI 53208-3987
Phone (414) 429-7880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1639401755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 W WISCONSIN AVE APT 205",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083987",
            "telephone_number": "414-429-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 W WISCONSIN AVE APT 205",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083987",
            "telephone_number": "414-429-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMIAH JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "LICENSED PRACTICAL NURSE",
        "authorized_official_telephone_number": "414-429-7880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "311777-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.