Individual provider Active NPI

Leonard Wesly Johnson

  • Driver
  • Las Vegas, NV
National Provider Identifier
1912770199
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
7100 Grand Montecito Pkwy Unit 1020
Las Vegas, NV 89149-0263
Phone
(725) 777-6590
NPI assigned
Oct 31, 2023
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X
Contractor 171W00000X
Driver 172A00000X 2000064787 NV
Driver 172A00000X Primary

Addresses

Primary practice location

7100 Grand Montecito Pkwy Unit 1020
Las Vegas, NV 89149-0263

Mailing address

7100 Grand Montecito Pkwy Unit 1020
Las Vegas, NV 89149-0263
Phone (725) 777-6590

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

LicenseStateTypeSpecialty
2000064787NVMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1912770199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 GRAND MONTECITO PKWY UNIT 1020",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490263",
            "telephone_number": "725-777-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 GRAND MONTECITO PKWY UNIT 1020",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490263",
            "telephone_number": "725-777-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LEONARD",
        "middle_name": "WESLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NV",
            "license": "2000064787",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.