Individual provider Active NPI

Bequandra Johnson

  • Durable Medical Equipment & Medical Supplies
  • Smyrna, GA
National Provider Identifier
1962201152
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
1836 Roswell St SE Apt 10407
Smyrna, GA 30080-2368
Phone
(470) 930-6372
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1836 Roswell St SE Apt 10407
Smyrna, GA 30080-2368

Mailing address

2955 Cobb Pkwy SE Ste 301
Atlanta, GA 30339-3523
Phone (470) 930-6372

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

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1962201152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 COBB PKWY SE STE 301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393523",
            "telephone_number": "470-930-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 ROSWELL ST SE APT 10407",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802368",
            "telephone_number": "470-930-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEQUANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.