Elizabeth Johnson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3165 McKelvey Rd Ste 200
Bridgeton, MO 63044-2550

Phone

(314) 206-3900

NPI assigned

Jan 12, 2018

Last updated

Jan 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1982112819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 MCKELVEY RD STE 200",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442550",
            "telephone_number": "314-206-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "634 N Main St Ste 4",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622693746",
            "country_code": "US",
            "telephone_number": "618-726-5870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "00004535",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amarilis Johnson
• Amber Renee Johnson, PAC MMS
• Angela B Johnson
• Aundrea Denise Johnson, PLPC
• Cherquita Johnson, LMT
• Haeley Renee Johnson
• Jessica Johnson
• Kevin Johnson, MD
• Krystal Johnson
• Ramona Lynn Johnson, LCSW

• Community Health Worker in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Community Health Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.