Active NPI
Sophia Johnson
- Pharmacist
- Storm Lake, IA
National Provider Identifier
1861003519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23688
- Practice address
- 1250 Lake Ave
Storm Lake, IA 50588-1997 - Phone
- (712) 732-1364
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23688 | IA | Primary |
Addresses
Primary practice location
1250 Lake Ave
Storm Lake, IA 50588-1997
Mailing address
1250 Lake Ave
Storm Lake, IA 50588-1997
Phone (712) 732-1364
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 712-732-2625 | Other |
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 |
|---|---|---|---|
| 23688 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1861003519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 LAKE AVE",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505881997",
"telephone_number": "712-732-1364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 LAKE AVE",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505881997",
"telephone_number": "712-732-1364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SOPHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23688",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "712-732-2625",
"affiliation": "N",
"endpointDescription": "fax",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Fax",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "1250 Lake Ave",
"city": "Storm Lake",
"state": "IA",
"country_code": "US",
"postal_code": "505881997",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Storm Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.