Theresa Ann Johnson

Primary specialty

PharmacistTaxonomy code 183500000X

License

051-039192 Issued in IL

Practice address

100 S High Cross Rd
Urbana, IL 61802-7804

Phone

(217) 390-0273

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medgenyx, PLLC

  • Point of Service
  • Urbana, IL
  • NPI 1679261358
  NPD Authorized official

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1639770985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 S STONE CREEK BLVD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618029667",
            "telephone_number": "217-355-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S HIGH CROSS RD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618027804",
            "telephone_number": "217-390-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-039192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie McKenzie Johnson
• Maddie R Johnson, NP
• Mark August Johnson, M.D.
• Patricia A Johnson, MD
• Philip B Johnson, M.D.
• Timothy James Johnson, MD
• Todd Richard Johnson, APRN
• Victoria J Johnson, MD
• Janet A Jokela, M.D.
• Brittany Jones

• Pharmacist in Urbana, IL
• Providers in Urbana, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.