Samuel Johnson, CPT, PN1, BCS, CES

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

5720 Stone Brook Dr
Brentwood, TN 37027-4640

Phone

(615) 972-3862

NPI assigned

Sep 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1669193116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 STONE BROOK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274640",
            "telephone_number": "615-972-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 STONE BROOK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274640",
            "telephone_number": "615-972-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMUEL",
        "credential": "CPT, PN1, BCS, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@travelfitco.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5720 Stone Brook Dr",
            "city": "Brentwood",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370274640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kendall Odell Johnson, PT
• Lacey Elizabeth Johnson, MMFT
• Malissa Marie Johnson
• Mark Johnson, MD
• Rhodona Kyle Johnson, CNIM
• Sara Johnson
• Thomas Glenn Johnson, LMFT
• Trent Johnson, DC
• Perry Johnston
• Emily Jokisch, MS, RD, LDN

• Nutritionist in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Nutritionist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.