Khadedra D Brown Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

330069 Issued in NY

Practice address

451 Mount Read Blvd
Rochester, NY 14606-1413

Phone

(585) 287-4291

NPI assigned

Feb 12, 2019

Last updated

Feb 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Khadedra D Brown Johnson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1871059089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 MOUNT READ BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146061413",
            "telephone_number": "585-287-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 MOUNT READ BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146061413",
            "telephone_number": "585-287-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN JOHNSON",
        "first_name": "KHADEDRA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "330069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHADEDRA",
            "last_name": "BROWN JOHNSON",
            "middle_name": "D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kassech Brouk, LPN
• Sean W Brouty, LMSW
• Donna Brower, RN,CDE
• Jennifer Brown Broderick, M.D.
• Naishah Brown Ebanks
• Taashire Brown Sanders
• Andreana Hariesha Brown-Cunningham
• Shannon Brown-Francione, FNP
• Alinda Brown
• Anissia Moneet Brown, LPN

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.