Individual provider Active NPI

Lisa Charles-Johnson

  • Registered Nurse
  • Rosenberg, TX
National Provider Identifier
1952888539
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
771103 Issued in TX
Practice address
1031 Mysterium LN
Rosenberg, TX 77469-2057
Phone
(817) 975-3289
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 771103 TX Primary

Addresses

Primary practice location

1031 Mysterium LN
Rosenberg, TX 77469-2057

Mailing address

1031 Mysterium LN
Rosenberg, TX 77469-2057
Phone (817) 975-3289

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
771103TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1952888539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 MYSTERIUM LN",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774692057",
            "telephone_number": "817-975-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MYSTERIUM LN",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774692057",
            "telephone_number": "817-975-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES-JOHNSON",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "771103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.