Active NPI
Kevin L Johnson, RP
- Pharmacist
- Lincoln, NE
National Provider Identifier
1669752200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9065
- Practice address
- 2600 S 48TH St
Lincoln, NE 68506-2502 - Phone
- (402) 483-2834
- Fax
- (402) 483-2076
- NPI assigned
- Aug 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9065 | NE | Primary |
| Pharmacist | 183500000X | PH3200 | HI | |
| Pharmacist | 183500000X | PHA19050 | CO |
Addresses
Primary practice location
2600 S 48TH St
Lincoln, NE 68506-2502
Mailing address
2600 S 48TH St
Lincoln, NE 68506-2502
Phone (402) 483-2834
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHA19050 | CO | MD | Pharmacist |
| PH3200 | HI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1669752200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 S 48TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062502",
"telephone_number": "402-483-2834",
"fax_number": "402-483-2076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 S 48TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062502",
"telephone_number": "402-483-2834",
"fax_number": "402-483-2076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KEVIN",
"middle_name": "L",
"credential": "RP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "9065",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH3200",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA19050",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.