Individual provider Active NPI

Elizabeth Elaine Johnson, CLD

  • Health Educator
  • Tucker, GA
National Provider Identifier
1760788988
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Practice address
4197 Hideaway Dr
Tucker, GA 30084-7804
Phone
(770) 862-7868
NPI assigned
Feb 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X Primary

Addresses

Primary practice location

4197 Hideaway Dr
Tucker, GA 30084-7804

Mailing address

4197 Hideaway Dr
Tucker, GA 30084-7804
Phone (770) 862-7868

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

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1760788988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4197 HIDEAWAY DR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847804",
            "telephone_number": "770-862-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4197 HIDEAWAY DR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847804",
            "telephone_number": "770-862-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "CLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.