MOBILE FNP JRJOHNSON NPI 1194382945

NPI Information

NPI: 1194382945
Provider Name: MOBILE FNP JRJOHNSON

Doing Business As: MOBILE FNP JR JOHNSON PLLC

Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 34D2194541

Address:
236 N MEBANE ST STE 123
BURLINGTON, NC
ZIP 27217
Phone: (336) 639-7149
Get Directions

MOBILE FNP JRJOHNSON is an addiction medicine family medicine in Burlington, NC. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. MOBILE FNP JRJOHNSON NPI is 1194382945. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mobile Fnp Jr Johnson Pllc.

The provider's business location address is:

236 N MEBANE ST STE 123
BURLINGTON, NC
ZIP 27217-900
Phone: (336) 639-7149
Fax: (336) 639-7141

The provider's authorized official is Julie Randolph Johnson .
The authorized official title is Owner and has the following contact phone number (336) 639-7149.

The CLIA number assigned to this NPI record is 34D2194541 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/28/2019 and was last updated on 10/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	261QH0100X	Clinic/Center	Health Service	No
3	261QP2300X	Clinic/Center	Primary Care	No
4	363L00000X	Nurse Practitioner		No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
6	363LP2300X	Nurse Practitioner	Primary Care	No
7	363LF0000X	Nurse Practitioner	Family	No
8	207QA0401X	Family Medicine	Addiction Medicine	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1013300383	MEDICAID	NORTH CAROLINA
2	1194382945	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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