MARY DANIEL JOHNSON


Address: 4802 E Johnson Ave, Jonesboro, AR 72405-8413
Phone: 8709368000

MARY DANIEL JOHNSON (NPI# 1487201703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487201703
Entity Type Individual
Full Name MARY DANIEL JOHNSON
Credential RD
Practice Address 4802 E Johnson Ave
Jonesboro
AR 72405-8413
Mailing Address Po Box 1960
Jonesboro
AR 72403-1960
Practice Telephone 8709368000
Practice Fax Number 8709343639
Mailing Telephone 8709368000
Mailing Fax Number 8709343639
Enumeration Date 2019-08-21
Last Update Date 2019-08-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered AR Dietary & Nutritional Service Providers

Office Location

Street Address 4802 E JOHNSON AVE
City JONESBORO
State AR
Zip Code 72405-8413

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699779686 Paul S Levy Thoracic Surgery (Cardiothoracic Vascular Surgery) 4802 E Johnson Ave, Jonesboro, AR 72401 2005-06-08
1316546138 Emily M Allen Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2020-10-22
1699387274 Sarah E Dulaney Clinical Nurse Specialist 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2020-08-17
1154965036 Danny Lee Ricker Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-11-04
1679117659 Ryan Scott Anderson Clinical Nurse Specialist 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-11-01
1366086787 Jennifer L Turnbow Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-10-29
1285288357 Kellye P Brown Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-07-28
1801448592 Helen F Williams Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-07-12
1801350285 Brandy N Herrington Physician Assistant 4802 E Johnson Ave, Jonesboro, AR 72401-8413 2019-01-30
1225512635 Stefanie Renee Brackin Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72401-8413 2018-09-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063023554 Christopher Marshall Dentist 1804 Old Greensboro Rd Bldg B, Jonesboro, AR 72405-0003 2020-08-10
1346841756 Hannah Beth Johnston Occupational Therapy Assistant 970 County Road 753, Jonesboro, AR 72405-0232 2020-11-03
1275168213 Blaine Carson Optometrist 3705 E Johnson Ave, Jonesboro, AR 72405-1858 2020-03-10
1669006359 Megan Maureen Anderson Nurse Practitioner 2712 E Johnson Ave, Jonesboro, AR 72405-1874 2020-03-03
1922539915 Whitney Taylor Registered Nurse 2712 E Johnson Ave, Jonesboro, AR 72405-1874 2017-03-22
1205211976 Higginbotham Dental Group, Pllc Dentist 1804 Old Greensboro Rd Ste D, Jonesboro, AR 72405-2076 2015-07-23
1265087092 Richardson Anesthesia Pllc Anesthesiology 320 County Road 794, Jonesboro, AR 72405-7087 2019-08-08
1194346304 Toni Cecil Student in an Organized Health Care Education/Training Program 4505 Mockernut Ln, Jonesboro, AR 72405-7848 2020-04-28
1992306534 Haley Elizabeth Ballard Case Manager/Care Coordinator 1815 Pleasant Grove Rd, Jonesboro, AR 72405-7870 2020-11-02
1457967986 Ana-liese Torres Case Manager/Care Coordinator 1815 Pleasant Grove Rd, Jonesboro, AR 72405-7870 2020-09-21
Find all providers in zip 72405

Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration.
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609129287 Tonya Nicole Cooksey Dietitian, Registered 2196 Talbot Rdg, Jonesboro, GA 30236-9018 2012-10-19
1457499915 Patricia Louise Thielemier Dietitian, Registered 538 E Washington Ave, Jonesboro, AR 72401-3109 2007-02-04
1174536312 Ashley Rusher Jones Dietitian, Registered 125 County Road 7452, Jonesboro, AR 72401-7951 2006-08-15
1013522408 Caitlin Rae Cothern Dietitian, Registered 416 E Washington Ave, Jonesboro, AR 72401-3108 2020-09-11
1740830421 Abigail Sarah Mcnatt Dietitian, Registered 416 E Washington Ave, Jonesboro, AR 72401-3108 2019-09-16
1922560044 Diet To Lifestyle LLC Dietitian, Registered 560 Highway 138 W, Jonesboro, GA 30238-2222 2019-04-06
1891230173 Briana Reynolds Dietitian, Registered 225 E Jackson Ave, Jonesboro, AR 72401-3119 2016-12-22
1558714063 Amanda Heringer Dietitian, Registered 1416 E Matthews Ave, St. Bernards Health and Wellness, Jonesboro, AR 72401-4362 2016-07-20
1255765459 Patricia Cronin Abraham Dietitian, Registered 311 S Church St, Suite C, Jonesboro, AR 72401-2913 2013-08-25
1841638954 Stacey Mccarroll Dietitian, Registered 1801 Grant Ave, Jonesboro, AR 72401-6155 2013-06-11
Find all providers in JONESBORO

Competitor

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City JONESBORO
Zip Code 72405

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Dataset Information

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.

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