CMS-1500 Box 24J / 33a • NPI
1184776379
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
376K00000X
Licensed & Credentialed Nurse's Aide
Box 32 Service Location & ZIP+4
W20298 STATE ROAD 121, WHITEHALL, WI, 54773-9685
✓ 9-Digit EDI 837 ZIP+4 (54773-9685)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184776379 (THELMA JOHNSON, CNA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184776379 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | THELMA JOHNSON, CNA |
| Plain-English Specialty | Licensed & Credentialed Nurse's Aide NUCC Code: 376K00000X (Nurse's Aide) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | W20298 STATE ROAD 121, WHITEHALL, WI, 54773-9685 |
| Practice Telephone / Fax | Tel: (715) 538-4312 | Fax: (715) 538-2426 |
| Administrative Mailing Address | W20298 STATE ROAD 121, WHITEHALL, WI, 54773-9685 |
| Enumeration & Last Sync | Enumerated: 2007-01-17 | CMS Record Updated: 2007-07-08 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (376K00000X)
What Does Taxonomy Code 376K00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 376K00000X translates to:
"Licensed & Credentialed Nurse's Aide"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (THELMA JOHNSON, CNA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
376K00000X — Nurse's AidePlain English: Licensed & Credentialed Nurse's Aide | State: WI | License: 117679 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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