Individual provider Active NPI

Stephanie Johnson

  • Driver
  • Hampton, VA
National Provider Identifier
1710643499
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
T60-34-4481 Issued in VA
Practice address
110 Coliseum Xing # 5165
Hampton, VA 23666-5971
Phone
(757) 814-3316
NPI assigned
Nov 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X T60-34-4481 VA Primary

Addresses

Primary practice location

110 Coliseum Xing # 5165
Hampton, VA 23666-5971

Mailing address

110 Coliseum Xing # 5165
Hampton, VA 23666-5971

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Trucking and Transport Driver CurrentSince Jan 2, 2022 Accepting new patients

Locations

110 Coliseum Xing
Hampton, VA 23666
Phone (757) 752-8682

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": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1710643499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLISEUM XING # 5165",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COLISEUM XING # 5165",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665971",
            "telephone_number": "757-814-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "VA",
            "license": "T60-34-4481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.