Peggy Lavern Johnson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

4455 Confederate Point Rd
Apartment 10-D
Jacksonville, FL 32210-5757

Phone

(904) 400-8723

Fax

(904) 374-5251

NPI assigned

Aug 29, 2013

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

Other identifiers 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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1669806345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 CONFEDERATE POINT RD",
            "address_2": "APARTMENT 10-D",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105757",
            "telephone_number": "904-400-8723",
            "fax_number": "904-374-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 CONFEDERATE POINT RD",
            "address_2": "APARTMENT 10-D",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105757",
            "telephone_number": "904-400-8723",
            "fax_number": "904-374-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PEGGY",
        "middle_name": "LAVERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691051396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Okeya Johnson
• Olivia A Johnson, FNP-BC
• Pamela S Johnson
• Patsy A. Johnson, CRNA
• Paul Kirk Johnson, ARNP
• Peyton Leigh Johnson
• Randall James Johnson, CRNA
• Rebecca Johnson
• Reece E Johnson
• Renee Johnson

• Personal Care Attendant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Personal Care Attendant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.