Johnny Dell Huffman, LPN, WCC, OMS

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2008009865 Issued in MO

Practice address

13834 Parks Steed Dr
Earth City, MO 63045-1405

Phone

(636) 244-5258

Fax

(636) 244-5261

NPI assigned

May 18, 2020

Last updated

May 18, 2020By 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

State licenses

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1639792203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13834 PARKS STEED DR",
            "city": "EARTH CITY",
            "state": "MO",
            "postal_code": "630451405",
            "telephone_number": "636-244-5258",
            "fax_number": "636-244-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13834 PARKS STEED DR",
            "city": "EARTH CITY",
            "state": "MO",
            "postal_code": "630451405",
            "telephone_number": "636-244-5258",
            "fax_number": "636-244-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "JOHNNY",
        "middle_name": "DELL",
        "name_prefix": "Mr.",
        "credential": "LPN, WCC, OMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2008009865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Earth City, MO
• Providers in Earth City, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.