RONALD R. JOHNSON (NPI# 1780885012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780885012 |
| Entity Type | Organization |
| Organization Name | RONALD R. JOHNSON |
| Other Organization Name | JOHNSON LLHCSA FREDONIA |
| Practice Address |
4883 W Main Rd Fredonia NY 14063-9509 |
| Practice Telephone | 7166794883 |
| Practice Fax Number | 7166794881 |
| Mailing Telephone | 7166794883 |
| Mailing Fax Number | 7166794881 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DEAN STANLEY BROWN (FINANCE DIRECTOR) |
| Authorized Official Telephone | 7169652644 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
0671A001 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01996758 | 05 |
| Other Name | Type Code |
|---|---|
| Johnson LLHCSA Fredonia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477754703 | Ronald R. Johnson | Custodial Care Facility | 2063 Route 83, Forestville, NY 14062-9639 | 2007-05-31 |
| 1013125467 | Ronald R. Johnson | Custodial Care Facility | 4460 Union Hill Rd, Hinsdale, NY 14743-9715 | 2007-05-18 |
| Street Address |
4883 W MAIN RD |
| City | FREDONIA |
| State | NY |
| Zip Code | 14063-9509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013516277 | Dawn J Manzella | Specialist | 135 W Mainn St, Fredonia, NY 14063 | 2020-10-20 |
| 1265909568 | Emily Marie Ludwig | Student in an Organized Health Care Education/Training Program | 3 Andrew Ct, Fredonia, NY 14063 | 2018-10-25 |
| 1275909129 | Diane Jo Rafan | Registered Nurse | 9705 Miller Rd, Fredonia, NY 14063 | 2015-08-14 |
| 1508281312 | Ann R Dutchess | Registered Nurse | Lakeside Clinic, 355 Central Ave, Fredonia, NY 14063 | 2014-03-03 |
| 1508134941 | Lauren Cecile Merlino | Speech-Language Pathologist | 9520 Fredonia-stockton Road, Lo Guidance Education Center, Fredonia, NY 14063 | 2011-12-13 |
| 1619287315 | Warren P. Sanderson | Registered Nurse | 264 East Main St, Fredonia, NY 14063 | 2010-10-15 |
| 1992020416 | Darwin's Health Club, Inc | Case Management | 47-53 Water Street, Fredonia, NY 14063 | 2010-03-29 |
| 1629255062 | Richard M Wright | Dentist | One Park Place, Suite #240, Fredonia, NY 14063 | 2008-01-29 |
| 1588845416 | Mark Twichell & Annette Lukasik Dds LLP | Dentist | 85 West Main Street, Fredonia, NY 14063 | 2007-11-20 |
| 1992911390 | Tracy Luise Stenger | Counselor | 105 Newton Street, Fredonia, NY 14063 | 2007-05-15 |
| Find all providers in zip 14063 | ||||
| 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] |
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|---|---|---|---|---|
| 1417557828 | Kenwood Manor Inc | Custodial Care Facility | 141 Rockefeller Rd, Delmar, NY 12054-2221 | 2020-10-27 |
| 1336748383 | Jjj Yaut, LLC | Custodial Care Facility | 4806 Ny 52, Jeffersonville, NY 12748 | 2020-10-21 |
| 1528683463 | Hanmaum Daycare LLC | Custodial Care Facility | 3238 148th St, Flushing, NY 11354-3259 | 2020-06-16 |
| 1538700158 | Parkview Hfa, Inc. | Custodial Care Facility | 3200 Bronx Blvd, Bronx, NY 10467-6305 | 2019-10-04 |
| 1457903437 | Prime Social Day Care | Custodial Care Facility | 1918 1st Ave 1st Floor, New York, NY 10029 | 2019-07-10 |
| 1477116457 | Caroline S Reuben | Custodial Care Facility | 17108 Jamaica Ave, Jamaica, NY 11432-5428 | 2019-04-16 |
| 1255898979 | Yan K Chan | Custodial Care Facility | 6504 Bay Pkwy, Brooklyn, NY 11204-3931 | 2019-02-28 |
| 1609357284 | Sun Sunshine Adult Daycare Ctr Inc | Custodial Care Facility | 738 58th St, Brooklyn, NY 11220-3917 | 2018-08-22 |
| 1285113548 | The House of Hope | Custodial Care Facility | 31 Standish Rd, Valley Stream, NY 11580-1131 | 2018-08-08 |
| 1083112940 | True Quality Care | Custodial Care Facility | 1616 Chili Ave, Rochester, NY 14624-3246 | 2018-01-25 |
| 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.