Keondra C Johnson
Intermediate Care Facility, Mentally Retarded

Address: 2140 Medical District Dr Apt 2052, Dallas, TX 75235-8097
Phone: 2146954955

Keondra C Johnson (NPI# 1578179750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1578179750
Entity Type Individual
Full Name Keondra C Johnson
Gender Female
Practice Address 2140 Medical District Dr Apt 2052
Dallas
TX 75235-8097
Practice Telephone 2146954955
Mailing Address 990 Highway 287 N Ste 106
Mansfield
TX 76063-2643
Mailing Telephone 2146954955
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2020-09-22
Last Update Date 2020-09-22

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 315P00000X Intermediate Care Facility, Mentally Retarded Nursing & Custodial Care Facilities

Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467838540 D&d Care Homes Texas LLC Intermediate Care Facility, Mentally Retarded 5218 Pershing St, Dallas, TX 75206-6524 2015-07-30
1144491556 Educare Community Living Corporation - Texas Intermediate Care Facility, Mentally Retarded 3111 Le Harve Dr, Dallas, TX 75211-1679 2008-03-13
1952572364 Educare Community Living Corporation - Texas Intermediate Care Facility, Mentally Retarded 5922 Lewisburg Ln, Dallas, TX 75237-2028 2008-03-13
1336368265 Dallas County Mhmr Intermediate Care Facility, Mentally Retarded 6946 Forest Ln, Dallas, TX 75230-2304 2007-04-25
1053530980 Dallas County Mhmr Intermediate Care Facility, Mentally Retarded 8014 Inwood Rd, Dallas, TX 75209-3336 2007-04-25
1659590586 Dallas County Mhmr Intermediate Care Facility, Mentally Retarded 14163 Haymeadow Dr, Dallas, TX 75254-2825 2007-04-25
1588737159 Evergreen Presbyterian Ministries of Texas, Inc. Intermediate Care Facility, Mentally Retarded 10810 Sanden Dr, Dallas, TX 75238-1337 2006-11-15
1912178252 Educare Community Living Corporation - Texas Intermediate Care Facility, Mentally Retarded 14255 Haymeadow Dr, Dallas, TX 75254-2827 2008-03-14
1730350075 Educare Community Living Corporation - Texas Intermediate Care Facility, Mentally Retarded 14163 Haymeadow Dr, Dallas, TX 75254-2825 2008-03-14
1437370293 Dallas County Mhmr Intermediate Care Facility, Mentally Retarded 14255 Haymeadow Dr, Dallas, TX 75254-2827 2007-05-01
Find all providers in DALLAS

Office Location

Street Address 2140 MEDICAL DISTRICT DR APT 2052
City DALLAS
State TX
Zip Code 75235-8097

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265058895 Kailey Elaine Flowers Physical Therapy Assistant 2400 Empire Central Drive, Suite B, Dallas, TX 75235 2020-06-19
1265061071 Bella Xinyi O'malley Student in an Organized Health Care Education/Training Program 1935 Medical Drive, Dallas, TX 75235 2020-04-03
1427687318 Can Ozlu Student in an Organized Health Care Education/Training Program Children's Medical Center of Dallas, 1935 Medical Distr, Dallas, TX 75235 2020-04-03
1689137515 Tarek Mansi Student in an Organized Health Care Education/Training Program 2222 Medical District Dr Apt 4325, Dallas, TX 75235 2019-04-08
1386117125 Christine Elizabeth Smith Physician Assistant 8134 Tex Oak Avenue, Dallas, TX 75235 2019-01-04
1447720016 Michelle Angelina Dye Physician Assistant 5959 Maple Avenue Apt 1171, Dallas, TX 75235 2018-11-27
1255869335 Andrea Nicole Pennington-peace Specialist/Technologist, Other 1935 Medial District, Dallas, TX 75235 2017-06-01
1194258152 Tricia Rood Student in an Organized Health Care Education/Training Program 5200 Harry Hines Blvd., Dallas, TX 75235 2017-04-06
1437690971 Robin Lee Counselor 8915 Hrry Hines Blvd, Dallas, TX 75235 2017-03-16
1871033746 Javier Davila-lopez Counselor 1545 Mockingbird Lane, Suite 4000, Dallas, TX 75235 2017-02-27
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Competitor

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City DALLAS
Zip Code 75235

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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.