CLAUDETTE JOHNSON (NPI# 1891170460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891170460 |
| Entity Type | Organization |
| Organization Name | CLAUDETTE JOHNSON |
| Practice Address |
4617 Hidden Shaddow Dt Tampa FL 33614 |
| Mailing Address |
4617 Hidden Shadow Dr Tampa FL 33614-1476 |
| Practice Telephone | 8135134616 |
| Mailing Telephone | 8135134616 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |
| Authorized Official Name | CLAUDETTE JOHNSON (PROVIDER) |
| Authorized Official Telephone | 8135134616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
311ZA0620X | FL | Nursing & Custodial Care Facilities |
| Street Address |
4617 HIDDEN SHADDOW DT |
| City | TAMPA |
| State | FL |
| Zip Code | 33614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025698 | Marcson Erdain | Custodial Care Facility | 2313 W Arch St, Tampa, FL 33607-5303 | 2019-07-18 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1437636024 | Tonia Hammond | Custodial Care Facility | 3819 Beechwood Blvd, Tampa, FL 33619-1224 | 2018-07-26 |
| 1295275360 | Myrta Cruz Rivera | Custodial Care Facility | 11008 N 52nd St, Tampa, FL 33617-2804 | 2017-03-08 |
| 1821532243 | Lawanza Llanos | Custodial Care Facility | 1911 E 143rd Ave, Tampa, FL 33613-2536 | 2016-12-05 |
| 1629526074 | Eakens Group Home | Custodial Care Facility | 8402 Rio Bravo Ct, 3, Tampa, FL 33617-7083 | 2016-09-14 |
| 1083072789 | Diane's Speial Home Care, Inc | Custodial Care Facility | 8206 Pennywell Pl, Tampa, FL 33615-1625 | 2016-02-09 |
| 1689030330 | Katherine Tillman | Custodial Care Facility | 8119 N Mulberry St, Tampa, FL 33604-3443 | 2016-01-11 |
| 1801269022 | Turning Pages LLC | Custodial Care Facility | 2931 Banza St, Tampa, FL 33605-2769 | 2015-11-10 |
| 1164800819 | Miledy Martinez | Custodial Care Facility | 6508 Amundson Ct, Tampa, FL 33634-4731 | 2015-05-14 |
| Find all providers in TAMPA | ||||
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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.