Adam Wade Johnson
Student in an Organized Health Care Education/Training Program in Memphis, TN. Individual provider (NPI-1).
NPI number1235964792
StatusActive
Last updated in NPPESSep 4, 2024
Details
- NPI
- 1235964792
- Entity type
- Individual (NPI-1)
- Name
- Adam Wade Johnson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 4, 2024
- Certification date
- Sep 4, 2024
- Last updated
- Sep 4, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
874 Union Ave Rm 325Memphis, TN 38103-3514
Phone 901-448-6128
Mailing address
874 Union Ave Rm 325Memphis, TN 38103-3514
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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