IDA JOHNICAN (NPI# 1134732290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134732290 |
| Entity Type | Individual |
| Full Name | IDA JOHNICAN |
| Practice Address |
491 S Sanga Rd Cordova TN 38018-7686 |
| Practice Telephone | 9012304309 |
| Mailing Telephone | 9012304309 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | Other Service Providers |
| Street Address |
491 S SANGA RD |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-7686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285100511 | Christopher Patterson | Driver | 7559 Emerald Greens Dr N, Cordova, TN 38016-5792 | 2018-10-14 |
| 1083977979 | Terrence Deshon Fisher | Driver | 1657 Belledeer Dr E, Cordova, TN 38016-0429 | 2012-06-17 |
| 1164987681 | Monica Walton | Driver | 7559 Emerald Greens Dr N, Cordova, TN 38016-5792 | 2019-02-08 |
| 1306222674 | Mario Wooden Sr. | Driver | 2336 Meverett Cv, Cordova, TN 38016-2341 | 2015-08-10 |
| 1437587748 | Lamus Rush IIi | Driver | 1105 Hunters Lake Dr, Cordova, TN 38018-1837 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809306 | J&j Senior Transportation and Concierge Svc | Driver | 3845 Viscount Ave Ste 305, Memphis, TN 38118-6024 | 2020-10-17 |
| 1750994588 | Advantage In-home Care Services LLC | Driver | 5371 Sunstone Cv, Memphis, TN 38109-6357 | 2020-08-31 |
| 1275144214 | Depree Chatman | Driver | 1049 N Idlewild St, Memphis, TN 38107-3002 | 2020-08-13 |
| 1164030052 | Ashley C Redd | Driver | 3007 Wentworth Ct, Murfreesboro, TN 37127-8346 | 2020-07-16 |
| 1093323172 | Daniel Timothy Davis | Driver | 1553 Brentwood Pointe, Franklin, TN 37067-1625 | 2020-07-15 |
| 1639795164 | Brenda Denise Haley I | Driver | 3272 Princeton Ave, Memphis, TN 38112-3114 | 2020-06-20 |
| 1841816576 | B&c Transporters LLC | Driver | 506 N Haven Ln, Hixson, TN 37343-3844 | 2020-06-18 |
| 1912521352 | Nikishia Burson | Driver | 2507 Dodson Ave, Chattanooga, TN 37406-2445 | 2020-06-02 |
| 1619591237 | Janice Newsom | Driver | 2200b Buchanan St # 2200b, Nashville, TN 37208-1912 | 2020-05-29 |
| 1316567274 | Chiquita White-thomason | Driver | 2500 Mount Moriah Rd Ste H212, Memphis, TN 38115-1523 | 2020-04-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.