Individual provider Active NPI

Wanda Yvette Johns

  • Registered Nurse
  • Virginia Beach, VA
National Provider Identifier
1669288494
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
00000 Issued in VA
Practice address
957 Carothers Arch
Virginia Beach, VA 23464-4085
Phone
(757) 637-1452
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001290842 VA
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 00000 VA Primary

Addresses

Primary practice location

957 Carothers Arch
Virginia Beach, VA 23464-4085

Mailing address

957 Carothers Arch
Virginia Beach, VA 23464-4085
Phone (757) 637-1452

Other identifiers 1

IdentifierTypeStateIssuer
00000000OtherVAVIRGINIA BOARD OF NURSING

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0001290842VAMDRegistered Nurse
00000VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1669288494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 CAROTHERS ARCH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644085",
            "telephone_number": "757-637-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 CAROTHERS ARCH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644085",
            "telephone_number": "757-637-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "WANDA",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001290842",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF NURSING",
            "identifier": "00000000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.