Katlynn Rose Johnson

Primary specialty

PharmacistTaxonomy code 183500000X

License

24235 Issued in IA

Practice address

3701 N 132ND St
Omaha, NE 68164-1849

Phone

(402) 431-0655

NPI assigned

Sep 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Omaha, NE
  • NPI 1801801857
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1861160632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W 6TH ST APT 3305",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 N 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681641849",
            "telephone_number": "402-431-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATLYNN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-05",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "17256",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "24235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katerra Lee Miller Johnson
• Katherine Johnson
• Katherine M Johnson
• Kathleen Diana Johnson
• Kathryn Ann Johnson
• Katrina Johnson
• Kaycee Elaine Johnson, CNA/QMA
• Kebra Johnson
• Keirra Johnson
• Kellie Johnson

• Pharmacist in Omaha, NE
• Providers in Omaha, NE by specialty
• Pharmacist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; 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.