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Deactivated NPI 1053638213 Deactivated / Inactive NPI Female Practitioner

Mathilda O Johnson , LPN

Licensed Practical Nurse • Milwaukee, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mathilda Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 28, 2010
NPI Deactivation Date April 12, 2022
Total Practice Duration ~12 Years of Practice (2010 – 2022)

Professional Overview & Biography Verified Profile Summary

Mathilda Johnson, LPN was a registered Licensed Practical Nurse practicing in Milwaukee, WI. Throughout an active medical career spanning 12 years, Mathilda Johnson provided care at the practice location at 1626 N PROSPECT AVE APT 805 until profile deactivation on 2022-04-12.

Practice Location & Contact Primary Location

Practice Address

1626 N Prospect Ave Apt 805

Milwaukee, WI 532022422

Telephone 6787990500

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Milwaukee, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
375 Specialists

Practicing in Milwaukee, WI (1775 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License WI 310559031

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 12, 2022

Record deactivated on April 12, 2022

NPI Profile Active April 28, 2010

NPI status registered as active in NPPES database

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Updated Practice Location April 28, 2010

Registered at 1626 N PROSPECT AVE APT 805, MILWAUKEE, WI 532022422 (Tel: 6787990500)

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Updated Business Mailing Address April 28, 2010

Registered at 1626 N PROSPECT AVE APT 805, MILWAUKEE, WI 532022422 (Tel: 6787990500)

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Provider Name / Credentials Updated April 28, 2010

Recorded as MATHILDA JOHNSON, LPN

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2010

Licensed Practical Nurse (License #310559031 in WI)

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Initial NPI Registration & Enumeration April 28, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053638213
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 28, 2010
Last Update: April 28, 2010
Deactivation Date: April 12, 2022

Mailing Address

1626 N Prospect Ave Apt 805

Milwaukee, WI 532022422

Phone: 6787990500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.