Individual provider Active NPI

Margie A Johnson, MSN, CPNP

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1700130465
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP120748 Issued in TX
Practice address
5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539
Phone
(210) 541-8281
Fax
(210) 541-9123
NPI assigned
Nov 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X 241949 TX
Pediatric Nurse Practitioner 363LP0200X AP120748 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539

Mailing address

5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539
Phone (210) 541-8281

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)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP120748TXMDPediatric Nurse Practitioner
241949TXMDPediatric Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Medical Center County of Victoria 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": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1700130465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD",
            "address_2": "SUITE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293539",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD",
            "address_2": "SUITE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293539",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARGIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TX",
            "license": "241949",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP120748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.