Active NPI
Brenda L Johnson, MS, RDN
- Registered Dietitian
- Papillion, NE
National Provider Identifier
1962041681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 885324
- Practice address
- 12383 S 78TH St
Papillion, NE 68046-4765 - Phone
- (405) 406-0126
- NPI assigned
- Dec 28, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 885324 | IL | Primary |
Addresses
Primary practice location
12383 S 78TH St
Papillion, NE 68046-4765
Mailing address
12383 S 78TH St
Papillion, NE 68046-4765
Phone (405) 416-0126
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 885324 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577491200000",
"number": "1962041681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12383 S 78TH ST",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464765",
"telephone_number": "405-416-0126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12383 S 78TH ST",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464765",
"telephone_number": "405-406-0126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRENDA",
"middle_name": "L",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-28",
"last_updated": "2019-12-28",
"certification_date": "2019-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "885324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.