Tabitha S Johnson, B-MOD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1407 10TH Ave S
Grand Forks, ND 58201-4351

Phone

(701) 795-3889

NPI assigned

May 16, 2024

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1821847385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 10TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014351",
            "telephone_number": "701-795-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 10TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014351",
            "telephone_number": "701-795-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TABITHA",
        "middle_name": "S",
        "credential": "B-MOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Johnson, MD
• Roger Lee Johnson, MSW, LICSW
• Stacey Lynne Johnson, OTR L
• Stefan Walter Johnson, MD
• Steven R Johnson, MD
• Alana Johnston
• Denise Mary Johnston, RN
• Stacy Jean Johnston, RN
• Angela Marie Jones, LAC
• Avery Thomas Jones, OD

• All providers in Grand Forks, ND
• Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.