GERALD B. JOHNSON – NPI #1609443217
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

GERALD JOHNSON is a community based residential treatment facility located in WASILLA, AK. NPPES has assigned the NPI number 1609443217 to GERALD JOHNSON on June 10, 2021. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was last updated on Oct 15, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GERALD JOHNSON below.

NPI Profile for
GERALD B. JOHNSON

NPI Number
1609443217
Enumeration Date

(about 5 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
GERALD B. JOHNSON
Primary location
4092 W MARBLE WAY
WASILLA, AK 99654-8752
Phone: (907) 227-3524 Fax:
Mailing address
Same as primary location
Sole Proprietor
Yes
Updated
Certification Date
Oct 15, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for GERALD JOHNSON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidAK1705395
medicaidAK1722922
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
AK

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.