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Keiba Deron Johnson

Physician β€’ Addison, TX

Deactivated NPI 1689554917 Deactivated in NPPES
Practice location in NPPES

17043 Planters Row
Addison, TX 750015037

Phone: 9452744947

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of September 09, 2025; the reason is not published. The records below are historical. They do not show whether Keiba Johnson currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date September 05, 2025
NPI Deactivation Date September 09, 2025
NPI Active Period 2025 – 2025

Practice Location & Contact Primary Location

Practice Address

17043 Planters Row

Addison, TX 750015037

Telephone 9452744947
Organization at the Same NPPES Address or Phone
Metronow Transportation Services Llc. Facility NPI 1871474742

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Addison and Texas

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Non-emergency Medical Transport (VAN) Primary Specialty

NUCC Taxonomy Code: 343900000X

A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated September 09, 2025

NPPES lists this NPI as deactivated as of September 09, 2025; the reason is not published.

βœ…
NPI Profile Active September 05, 2025

NPI status registered as active in NPPES database

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Practice Location (Initial Record) September 05, 2025

Registered at 17043 PLANTERS ROW, ADDISON, TX 750015037 (Tel: 9452744947)

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Business Mailing Address (Initial Record) September 05, 2025

Registered at 17043 PLANTERS ROW, ADDISON, TX 750015037 (Tel: 9452744947)

πŸ‘€
Provider Name / Credentials (Initial Record) September 05, 2025

Recorded as KEIBA JOHNSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 05, 2025

Non-emergency Medical Transport (VAN)

🟒
Initial NPI Registration & Enumeration September 05, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1689554917
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 05, 2025
Last Update: September 05, 2025
Deactivation Date: September 09, 2025

Mailing Address

17043 Planters Row

Addison, TX 750015037

Phone: 9452744947

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.