Active NPI
Stephanie Johnston, MS, LN
- Nutritionist
- Rio Rancho, NM
National Provider Identifier
1649627902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- LN-1082
- Practice address
- 1721 Rio Rancho Dr SE
Rio Rancho, NM 87124-1570 - Phone
- (505) 896-8600
- Fax
- (505) 896-8687
- NPI assigned
- May 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | LN-1082 | NM | Primary |
Addresses
Primary practice location
1721 Rio Rancho Dr SE
Rio Rancho, NM 87124-1570
Mailing address
1721 Rio Rancho Dr SE
Rio Rancho, NM 87124-1570
Phone (505) 896-8600
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LN-1082 | NM | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1649627902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 RIO RANCHO DR SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241570",
"telephone_number": "505-896-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 RIO RANCHO DR SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241570",
"telephone_number": "505-896-8600",
"fax_number": "505-896-8687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "STEPHANIE",
"name_prefix": "Ms.",
"credential": "MS, LN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-17",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NM",
"license": "LN-1082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.