MEDICARE: KAMANI SANIYYA JOHNSON-O'NEAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide		OH

General Provider Information

NPI Number	:	1316872914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMANI SANIYYA JOHNSON-O'NEAL

Provider Business Mailing Address
First Line	:	1724 WOODCREST RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2757
Country	:	US
Telephone Number	:	614-440-7813
Fax Number	:	614-440-7813

Provider Business Practice Location Address
First Line	:	1724 WOODCREST RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2757
Country	:	US
Telephone Number	:	614-440-7813
Fax Number	:	614-440-7813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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