Active NPI
Stephanie Jordan Johnson
- Home Health Agency
- Macon, GA
National Provider Identifier
1790934560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 011-R-0359
- Practice address
- 3839 Atwood Dr
Macon, GA 31204-5620 - Phone
- (478) 757-8982
- NPI assigned
- Sep 16, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 011-R-0359 | GA | Primary |
Addresses
Primary practice location
3839 Atwood Dr
Macon, GA 31204-5620
Mailing address
3839 Atwood Dr
Macon, GA 31204-5620
Phone (478) 757-8982
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 |
|---|---|---|---|
| 011-R-0359 | GA | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1790934560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3839 ATWOOD DR",
"city": "MACON",
"state": "GA",
"postal_code": "312045620",
"telephone_number": "478-757-8982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3839 ATWOOD DR",
"city": "MACON",
"state": "GA",
"postal_code": "312045620",
"telephone_number": "478-757-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "STEPHANIE",
"middle_name": "JORDAN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "GA",
"license": "011-R-0359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.