Individual provider Active NPI

John A Johnson, LPN

  • Licensed Practical Nurse
  • Milwaukee, WI
National Provider Identifier
1689016966
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2957931 Issued in WI
Practice address
9104 N 75TH St
Apt. 3a
Milwaukee, WI 53223-2064
Phone
(414) 758-8894
NPI assigned
Jul 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2957931 WI Primary

Addresses

Primary practice location

9104 N 75TH St
Apt. 3a
Milwaukee, WI 53223-2064

Mailing address

9104 N 75TH St
Apt. 3a
Milwaukee, WI 53223-2064
Phone (414) 758-8894

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
2957931WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1689016966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 N 75TH ST",
            "address_2": "APT. 3A",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232064",
            "telephone_number": "414-758-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 N 75TH ST",
            "address_2": "APT. 3A",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232064",
            "telephone_number": "414-758-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "2957931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.