Demetria Johnson

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

0001264629 Issued in VA

Practice address

11206 Abbots Cross LN
Glen Allen, VA 23059-1106

Phone

(516) 410-7618

NPI assigned

Sep 22, 2023

Last updated

Sep 22, 2023By the provider in NPPES

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

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1659150456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 SADLER PL UNIT 2621",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230581225",
            "telephone_number": "516-410-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11206 ABBOTS CROSS LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230591106",
            "telephone_number": "516-410-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEMETRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "VA",
            "license": "0001264629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Henderson, LCSW, LLC
• John J. Andre, D.D.S., P.C. and Associates
• Brittany Nicole Johnson, LPC
• Carnell D Johnson
• Darryl Lamont Johnson Jr.
• Erin Marie Johnson
• Lydia Jones Johnson, MD
• Sarah Johnson
• Tara Veronica Johnson, MS, LPC
• Zelda West Johnson, M.D.

• Administrator Registered Nurse in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Administrator Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.