Individual provider Active NPI

Samantha Jordan Johnson

  • Professional Counselor
  • Sun Prairie, WI
National Provider Identifier
1750186557
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8297226 Issued in WI
Practice address
1051 Okeeffe Ave Apt 150
Sun Prairie, WI 53590-4142
Phone
(608) 513-3080
NPI assigned
Feb 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8297226 WI Primary

Addresses

Primary practice location

1051 Okeeffe Ave Apt 150
Sun Prairie, WI 53590-4142

Mailing address

1051 Okeeffe Ave Apt 150
Sun Prairie, WI 53590-4142
Phone (608) 513-3080

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

LicenseStateTypeSpecialty
8297226WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1750186557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 OKEEFFE AVE APT 150",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904142",
            "telephone_number": "608-513-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 OKEEFFE AVE APT 150",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904142",
            "telephone_number": "608-513-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "middle_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8297226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.