Active NPI
Lynette Johnson
- Pharmacist
- Green Cove Springs, FL
National Provider Identifier
1699379982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS47945
- Practice address
- 800 N Orange Ave
Green Cove Springs, FL 32043-2526 - Phone
- (904) 284-5653
- NPI assigned
- Nov 26, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS47945 | FL | Primary |
Addresses
Primary practice location
800 N Orange Ave
Green Cove Springs, FL 32043-2526
Mailing address
800 N Orange Ave
Green Cove Springs, FL 32043-2526
Phone (904) 284-5653
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS47945 | Other | FL | LICENSE NUMBER |
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 |
|---|---|---|---|
| PS47945 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1699379982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 N ORANGE AVE",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320432526",
"telephone_number": "904-284-5653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 N ORANGE AVE",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320432526",
"telephone_number": "904-284-5653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LYNETTE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-26",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS47945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PS47945",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Cove Springs, FL
- Alicia Jacobs, LMT
- Deborah Ann Jacobs, ARNP
- William Anderson Jacobs, MD
- JGC Behavior Consulting LLC
- Katrina Johnson
- Norma S. Kempton, RPH
- Lynn Kettell-Slifer, ARNP
- Kindred Hospitals East, LLC (Kindred Hospital - North Florida (Acute Rehab Unit))
- Kindred Hospitals East, LLC (Kindred Hospital - North Florida)
- Kindred Hospitals East, LLC (d/b/a Kindred Hospital - North Florida)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.