Active NPI
Sarah Lynn Olmedo-Johnson
- Social Worker
- Biloxi, MS
National Provider Identifier
1720713233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 116727
- Practice address
- 1612 Saint Ann Ave
Biloxi, MS 39531-3416 - Phone
- (228) 261-3645
- NPI assigned
- Jul 19, 2022
- Last updated
- Aug 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4945G | AL | |
| Social Worker | 104100000X | M8998 | MS | |
| Social Worker | 104100000X | 116727 | NY | Primary |
Addresses
Primary practice location
1612 Saint Ann Ave
Biloxi, MS 39531-3416
Mailing address
1612 Saint Ann Ave
Biloxi, MS 39531-3416
Phone (228) 261-3645
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M8998 | Other | MS | MISSISSIPPI BOARD OF EXAMINERS FOR SOCIAL WORKERS AND FAMILY&MARRIAGE THERAPISTS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Other |
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 |
|---|---|---|---|
| 4945G | AL | MD | Social Worker |
| M8998 | MS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1720713233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1612 SAINT ANN AVE",
"city": "BILOXI",
"state": "MS",
"postal_code": "395313416",
"telephone_number": "228-261-3645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1612 SAINT ANN AVE",
"city": "BILOXI",
"state": "MS",
"postal_code": "395313416",
"telephone_number": "228-261-3645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLMEDO-JOHNSON",
"first_name": "SARAH",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-19",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AL",
"license": "4945G",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MS",
"license": "M8998",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "116727",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI BOARD OF EXAMINERS FOR SOCIAL WORKERS AND FAMILY&MARRIAGE THERAPISTS",
"identifier": "M8998",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Other",
"affiliation": "N",
"address_1": "1612 Saint Ann Ave",
"city": "Biloxi",
"state": "MS",
"country_code": "US",
"postal_code": "395313416",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.