Individual provider Active NPI

Tanecia Johnson, LPN

  • Licensed Practical Nurse
  • Maple Heights, OH
National Provider Identifier
1972921740
Registry record updated Mar 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
139528 Issued in OH
Practice address
14905 Krems Ave
Maple Heights, OH 44137-3617
Phone
(216) 326-9553
NPI assigned
Mar 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 139528 OH Primary

Addresses

Primary practice location

14905 Krems Ave
Maple Heights, OH 44137-3617

Mailing address

14905 Krems Ave
Maple Heights, OH 44137-3617
Phone (216) 326-9553

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
139528OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396137600000",
    "number": "1972921740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14905 KREMS AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373617",
            "telephone_number": "216-326-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14905 KREMS AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373617",
            "telephone_number": "216-326-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TANECIA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-30",
        "last_updated": "2014-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "139528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; 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.