Active NPI
Johnnie Darryl Johnson, CNA
- Nurse's Aide
- Greenwood, AR
National Provider Identifier
1922317775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 050283161209E
- Practice address
- 811 W Baltimore St
Greenwood, AR 72936-4544 - Phone
- (479) 597-8434
- NPI assigned
- Sep 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 050283161209E | AR | Primary |
Addresses
Primary practice location
811 W Baltimore St
Greenwood, AR 72936-4544
Mailing address
811 W Baltimore St
Greenwood, AR 72936-4544
Phone (479) 597-8434
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 |
|---|---|---|---|
| 050283161209E | AR | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285632000000",
"number": "1922317775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 W BALTIMORE ST",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "729364544",
"telephone_number": "479-597-8434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 W BALTIMORE ST",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "729364544",
"telephone_number": "479-597-8434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOHNNIE",
"middle_name": "DARRYL",
"name_prefix": "Mr.",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-28",
"last_updated": "2010-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "AR",
"license": "050283161209E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.