Tawanda Johnson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R864204 Issued in MS

Practice address

15055 Collection Center Dr
Chicago, IL 60693-0150

Phone

(256) 383-3325

Fax

(256) 383-5911

NPI assigned

Nov 14, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD
• Alliance Oncology LLC

  • Radiation Oncology Physician
  • Joplin, MO
  • NPI 1144416389
  NPD (past)

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1871923771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 E UNION ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033248",
            "telephone_number": "662-332-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15055 COLLECTION CENTER DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606930150",
            "telephone_number": "256-383-3325",
            "fax_number": "256-383-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAWANDA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R864204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02602740",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sukina T Johnson, PHARM.D
• Sydney Paige Johnson
• Tahnee Johnson
• Tasha Johnson
• Tashanda Johnson
• Taylor Danielle Johnson
• Taylor M Johnson, LCSW
• Tejoni Johnson
• Tete Johnson
• Teti Johnson, NURSE PRACTITIONER

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.