Individual provider Active NPI

Maria Tersea Johnson, RN

  • Home Health Registered Nurse
  • Albany, NY
National Provider Identifier
1669654604
Registry record updated Dec 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
517109 Issued in NY
Practice address
113 Benson St
Albany, NY 12206-2122
Phone
(518) 365-0018
NPI assigned
Dec 1, 2007
Last updated
Dec 1, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 517109 NY Primary

Addresses

Primary practice location

113 Benson St
Albany, NY 12206-2122

Mailing address

1137 Raymond Rd
Ballston Spa, NY 12020-3719
Phone (518) 365-0018

Other identifiers 1

IdentifierTypeStateIssuer
02733535MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
517109NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1196467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196467200000",
    "number": "1669654604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 RAYMOND RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203719",
            "telephone_number": "518-365-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BENSON ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062122",
            "telephone_number": "518-365-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIA",
        "middle_name": "TERSEA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-01",
        "last_updated": "2007-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "517109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02733535",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2007; 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.