MS. NEDRA JOHNSON (NPI# 1265941512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265941512 |
| Entity Type | Individual |
| Full Name | MS. NEDRA JOHNSON |
| Practice Address |
5049 Urban Ave Dallas TX 75227-2776 |
| Practice Telephone | 2142800379 |
| Mailing Telephone | 2142800379 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2020-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528257359 | Nedra D Johnson | Nurse Practitioner | 1010 Village Dr, Watkinsville, GA 30677-6004 | 2007-10-17 |
| 1437372711 | Nedra Kay Johnson | Marriage & Family Therapist | 3172 Walford Ave, Suite 4, Eureka, CA 95503-4827 | 2007-04-11 |
| Street Address |
5049 URBAN AVE |
| City | DALLAS |
| State | TX |
| Zip Code | 75227-2776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835703 | A Angel'stouch Hcs | Day Training, Developmentally Disabled Services | 5049 Urban Ave, Dallas, TX 75227-2776 | 2020-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760855464 | Narges S Afkami | Chiropractor | 4808 S. Buckner Blvd., Dallas, TX 75227 | 2015-11-04 |
| 1780902809 | Zachary Thomas Ripp | Obstetrics & Gynecology | 2959 S. Buckner Ste 100, Mi Doctor/ Women's Specialty Center, Dallas, TX 75227 | 2010-05-13 |
| 1386884922 | Valentino L Gonzales | Counselor | 5409 Jim Miller Rd, Suite 203a, Dallas, TX 75227 | 2009-02-23 |
| 1093951733 | Kofo A Aderemi | Durable Medical Equipment & Medical Supplies | 4617 S. Buckner Blvd., Suite J, Dallas, TX 75227 | 2008-12-31 |
| 1619146727 | Faith Assisted Living, LLC | Assisted Living Facility | 2155 Gaylord Dr, Dallas, TX 75227 | 2008-02-22 |
| 1619159241 | Epic Business Solutions | Durable Medical Equipment & Medical Supplies | 4801 South Buckner Blvd., Suite 1300, Dallas, TX 75227 | 2007-12-05 |
| 1356553838 | Cox Adult Foster Home | Custodial Care Facility | 8717 Blossom Lane, Dallas, TX 75227 | 2007-05-04 |
| 1386866903 | Injury Assistance C Enters, Inc. | Chiropractor | 2514 S. Buckner Blvd., Dallas, TX 75227 | 2007-05-03 |
| 1083836613 | Fiesta Pharmacy | Pharmacist | 2947 S Buckner Suite 500, Dallas, TX 75227 | 2007-05-03 |
| 1720164346 | Joe R Gosham | Dentist | 2222 Prairie Creek Rd, Dallas, TX 75227 | 2006-10-27 |
| Find all providers in zip 75227 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770107831 | American Roses Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6330 S Lancaster Rd, Dallas, TX 75241-3800 | 2020-06-04 |
| 1841839727 | Bellview Advocacy Project LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14606 Dallas Pkwy Apt 1111, Dallas, TX 75254-7451 | 2019-12-25 |
| 1740832021 | Brittany Dory | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8004 W Virginia Dr Apt 908, Dallas, TX 75237-4425 | 2019-07-16 |
| 1235621368 | Infinite Hope Hcs, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4650 S Hampton Rd Ste 11, Dallas, TX 75232-1066 | 2018-06-04 |
| 1295246916 | Camilla Medina | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 Amos St, Dallas, TX 75212-5202 | 2017-10-20 |
| 1619351665 | Kimberly Hutchings | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9670 Forest Ln Apt 1109, Dallas, TX 75243-8639 | 2015-07-18 |
| 1346620259 | Sherry Clark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7030 Capella Park Ave, Dallas, TX 75236-3003 | 2015-06-05 |
| 1710377726 | U-niq Identity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 917 Fordham Rd, Dallas, TX 75216-6133 | 2015-01-28 |
| 1356747554 | A Su Lado Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Main St Apt 202, Dallas, TX 75202-4300 | 2014-11-15 |
| 1477957405 | Amethyst Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5863 Foxglove Ln, Dallas, TX 75249-1625 | 2014-10-20 |
| Find all providers in DALLAS | ||||
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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.