Active NPI
Shaquana Johnson, LPN
- Licensed Practical Nurse
- Bronx, NY
National Provider Identifier
1699238352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 332152
- Practice address
- 1775 Grand Concourse
Bronx, NY 10453-8202 - Phone
- (347) 443-0809
- NPI assigned
- Apr 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 332152 | NY | Primary |
Addresses
Primary practice location
1775 Grand Concourse
Bronx, NY 10453-8202
Mailing address
1775 Grand Concourse FL 8
Bronx, NY 10453-8202
Other practice location 1
71 W 23rd St
New York, NY 10010-4102
Phone (212) 576-4104
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 |
|---|---|---|---|
| 332152 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Postgraduate Center for Mental Health | Past | Accepting new patients | |
| Coordinated Behavioral Care Ipa Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Bronx, NY
- NPI 1457881443
-
- Community/Behavioral Health Agency
- New York, NY
- NPI 1629127725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1699238352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 GRAND CONCOURSE FL 8",
"city": "BRONX",
"state": "NY",
"postal_code": "104538202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104538202",
"telephone_number": "347-443-0809"
}
],
"practiceLocations": [
{
"address_1": "71 W 23rd St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100104102",
"country_code": "US",
"telephone_number": "212-576-4104",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHAQUANA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-10",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "332152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.