Dominque Johnson

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH14112 Issued in FL

Practice address

5233 Ricker Rd Ste 102
Jacksonville, FL 32210-1439

Phone

(904) 320-0706

NPI assigned

Jun 24, 2022

Last updated

Jun 24, 2022By 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

State licenses

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1750013199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 GATE PKWY W UNIT 1718",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161054",
            "telephone_number": "850-339-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 RICKER RD STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101439",
            "telephone_number": "904-320-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOMINQUE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deatra L Johnson, PHARMD
• Deirdre Janel Johnson, M.A
• Derekia Johnson
• Diana L Johnson, M.D.
• Dianne Laroche Johnson, M.D.
• Donald Wayne Johnson Jr., PHARMD
• Douglas William Johnson, M.D.
• Elizabeth Johnson, MD
• Elizabeth Mary Johnson, M.D.
• Emily Dunn Johnson

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.