NPI Code Detail JSON Logo

1134085210 NPI number — MATILDA JOHNSON RDN, MS, MPH, PHD

NPI Number: 1134085210
Health Care Provider/Practitioner: MATILDA JOHNSON RDN, MS, MPH, PHD

Information about “1134085210” NPI (MATILDA JOHNSON RDN, MS, MPH, PHD) exists in 1134085210 in HTML format HTML  |  1134085210 in plain Text format TXT  |  1134085210 in PDF (Portable Document Format) PDF  |  1134085210 in an XML format XML  formats.

NPI Number : 1134085210 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134085210",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "MATILDA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "RDN, MS, MPH, PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2258 WHEYSTONE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VIENNA",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22182-5237",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-720-0998",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2258 WHEYSTONE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VIENNA",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22182-5237",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-720-0998",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/01/2026",
    "LastUpdateDate": "01/01/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "133V00000X",
        "TaxonomyName": "Registered Dietitian",
        "LicenseNumber": "DX7522",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.