TARA DEMETRIA JOHNSON (NPI# 1851883706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851883706 |
| Entity Type | Individual |
| Full Name | TARA DEMETRIA JOHNSON |
| Practice Address |
226 Abalone Rd Nw Palm Bay FL 32907-2964 |
| Mailing Address |
304 Hanford Rd Sw Palm Bay FL 32908-1200 |
| Practice Telephone | 3214804052 |
| Mailing Telephone | 3214804052 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | ALF13181 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023517000 | Tara Johnson | Licensed Practical Nurse | Lpsdo 5905 O St, Lincoln, NE 68510 | 2018-02-06 |
| 1275045098 | Tara Johnson | Specialist | 702 Academy Ave Ste B, Dublin, GA 31021-4084 | 2017-11-02 |
| 1174079602 | Tara Johnson | Nurse Practitioner | 241 Varden Hill Dr, Birmingham, AL 35214-1945 | 2016-08-25 |
| 1427356781 | Tara Johnson | Case Manager/Care Coordinator | 137 Farnsworth Blvd, Soldotna, AK 99669-7601 | 2011-03-09 |
| 1902101405 | Tara Johnson | Licensed Practical Nurse | 4850 Wilson Burt Rd, Wilson, NY 14172-9654 | 2011-01-14 |
| 1982906111 | Tara Denise Johnson | Technician | 1749 E Fremont Rd, Phoenix, AZ 85042-5740 | 2010-11-19 |
| 1316557838 | Tara Johnson | Peer Specialist | 602 Sw 38th St, Lawton, OK 73505-6912 | 2020-08-10 |
| 1447899638 | Tara Lashay Johnson | Chiropractor | 3417 Shelby Ray Ct, Charleston, SC 29414-5895 | 2020-01-06 |
| 1174081715 | Tara Johnson | Nurse Practitioner | 3801 Blue Pkwy, Kansas City, MO 64130-2807 | 2019-03-02 |
| 1477046233 | Tara K Johnson | Occupational Therapist | 7055 Mexico Rd Unit 1601, Saint Peters, MO 63376-2344 | 2018-06-07 |
| Street Address |
226 ABALONE RD NW |
| City | PALM BAY |
| State | FL |
| Zip Code | 32907-2964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679055602 | Rome's Paradise Assisted Living LLC | Assisted Living Facility | 226 Abalone Rd Nw, Palm Bay, FL 32907-2964 | 2018-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015109 | Tyreak Albert Mclarty | Behavior Technician | 2180 Julian Ave Nw, Palm Bay, FL 32907 | 2020-05-21 |
| 1871073759 | Jessica Elizabeth Ford | Physical Therapist | 470 Malabar Rd Se Unit 102, Palm Bay, FL 32907 | 2018-08-20 |
| 1598264558 | Corey Williams | Case Management | 1850 Delki St. Nw, Palm Bay, FL 32907 | 2018-02-06 |
| 1386154904 | Lauren Nicole Meek | Social Worker | 550 Malabar Rd Sw Apt 202, Palm Bay, FL 32907 | 2017-10-10 |
| 1679002877 | Kandice Monique Hearns | Physical Therapy Assistant | 175 Ne Villa Nueva Ave, Palm Bay, FL 32907 | 2017-06-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1467992107 | Enrique Martinez | Counselor | 1510 Studley Dr. Nw, Palm Bay, FL 32907 | 2017-02-28 |
| 1144776469 | Stephanie Ann Hoenig | Physical Therapy Assistant | 1155 Malabar Rd Se, Palm Bay, FL 32907 | 2016-08-28 |
| 1124471529 | K & S Tender Care 11 | Assisted Living Facility | 226 Abalone Road Ne, Palm Bay, FL 32907 | 2016-07-20 |
| 1235507781 | Jai Ho LLC | Specialist | 1663 Georgia Street, Suite 400, Palm Bay, FL 32907 | 2015-09-14 |
| Find all providers in zip 32907 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205787 | Pd & Sr, L.L.C. | Assisted Living Facility | 730 Frisco St Se, Palm Bay, FL 32909-3711 | 2020-11-06 |
| 1003423294 | Rome's Paradise Assisted Living II | Assisted Living Facility | 564 Delmonico St Ne, Palm Bay, FL 32907-3129 | 2020-09-30 |
| 1447881297 | Shangri-la of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1871136127 | Lucienne Cajuste Delva | Assisted Living Facility | 1246 Harlingen Rd Sw, Palm Bay, FL 32908-7146 | 2019-10-18 |
| 1811483290 | Welcome Home Assisted Living Facility LLC | Assisted Living Facility | 1387 San Cortez Ave Ne, Palm Bay, FL 32907-1118 | 2018-07-09 |
| 1437640653 | Hannah's Home LLC | Assisted Living Facility | 997 Lyons Cir Nw, Palm Bay, FL 32907-5911 | 2018-05-23 |
| 1447756655 | Glenville Pines II Assisted Living Facility LLC | Assisted Living Facility | 211 Silver Oak Rd Ne, Palm Bay, FL 32907-5582 | 2018-04-05 |
| 1982107678 | Serenity Lifestyle Plus | Assisted Living Facility | 178 Evergreen St Ne, Palm Bay, FL 32907-1905 | 2018-03-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1952836736 | Blue Fountain II Home Care, LLC. | Assisted Living Facility | 1310 Sequoia Rd Nw, Palm Bay, FL 32907-2780 | 2017-04-28 |
| Find all providers in PALM BAY | ||||
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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.