Individual provider Active NPI

Ronda Johnson, LPN

  • Licensed Practical Nurse
  • Smithville, TN
National Provider Identifier
1679976336
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
61424 Issued in TN
Practice address
254 Tiger Dr
Smithville, TN 37166-6812
Phone
(615) 597-7599
Fax
(615) 597-1349
NPI assigned
Oct 8, 2014
Sex
Female
Sole proprietor
Yes

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
61424TNMDLicensed Practical Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 61424 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

254 Tiger Dr
Smithville, TN 37166-6812

Mailing address

254 Tiger Dr
Smithville, TN 37166-6812
Phone (615) 597-7599

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 8, 2014.

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1679976336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 TIGER DR",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371666812",
            "telephone_number": "615-597-7599",
            "fax_number": "615-597-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 TIGER DR",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371666812",
            "telephone_number": "615-597-7599",
            "fax_number": "615-597-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RONDA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "61424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.