NPI Code Detail JSON Logo

1477448249 NPI number — JOHNSON DIAGNOSTIC LLC

NPI Number: 1477448249
Health Care Provider/Practitioner: JOHNSON DIAGNOSTIC LLC

Information about “1477448249” NPI (JOHNSON DIAGNOSTIC LLC) exists in 1477448249 in HTML format HTML  |  1477448249 in plain Text format TXT  |  1477448249 in PDF (Portable Document Format) PDF  |  1477448249 in an XML format XML  formats.

NPI Number : 1477448249 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477448249",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "JOHNSON DIAGNOSTIC LLC",
    "ParentOrgTIN": null,
    "OrgName": "JOHNSON DIAGNOSTIC LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "121 FRONT STREET",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PURVIS",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39475",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "833-385-3874",
    "MailingAddressFaxNumber": "601-861-4433",
    "FirstLinePracticeLocationAddress": "121 FRONT STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PURVIS",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39475",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "833-385-3874",
    "PracticeLocationAddressFaxNumber": "601-861-4433",
    "EnumerationDate": "06/11/2025",
    "LastUpdateDate": "06/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JOHNSON",
    "AuthorizedOfficialFirstName": "WANKETHIA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "833-385-3874",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251E00000X",
          "TaxonomyName": "Home Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251F00000X",
          "TaxonomyName": "Home Infusion Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "343900000X",
          "TaxonomyName": "Non-emergency Medical Transport (VAN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385H00000X",
          "TaxonomyName": "Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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