Jackie Johnson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2605 Rainbow Glow St
North Las Vegas, NV 89030-3709

Phone

(702) 630-5009

Fax

(702) 631-9821

NPI assigned

May 29, 2014

Last updated

May 29, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elevate Life

  • Mental Health Counselor
  • North Las Vegas, NV
  • NPI 1033436787
  NPD (past)
• Elevate Life Family Services, LLC

  • Behavior Analyst
  • North Las Vegas, NV
  • NPI 1568725935
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1740692318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 N JONES BLVD",
            "address_2": "APT2101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891086551",
            "telephone_number": "702-561-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 RAINBOW GLOW ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303709",
            "telephone_number": "702-630-5009",
            "fax_number": "702-631-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dionna M Johnson
• Dominique Johnson
• Felicia Johnson
• Gary D Johnson
• Henry A Johnson
• James Johnson
• Jane Marie Johnson, PEER CERTIFICATION
• Jasper Johnson
• Jeannette Lynn Johnson, NA
• Joshua Johnson

• Behavior Analyst in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.