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NPISignal

Individual Healthcare Provider

Raeanne Tatem Johnson, RN,MSN,CPNP-PC

NPI Record: ActivePediatrics — Developmental - Behavioral Pediatrics
NPI1245639830
Knightdale, North Carolina

Provider's NPPES record last updated: July 11, 2022

Overview

Entity Type
Individual Healthcare Provider
NPI
1245639830
Primary Specialty
Pediatrics — Developmental - Behavioral Pediatrics
Practice Location
Knightdale, North Carolina
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 21, 2026, 1:41 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Pediatrics

    Developmental - Behavioral Pediatrics

    Allopathic & Osteopathic Physicians

    Primary

    A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

    Taxonomy code 2080P0006X
  • Nurse Practitioner

    Pediatrics

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LP0200X

Provider-Reported License Information

Pediatrics (North Carolina)
20227375
Nurse Practitioner (North Carolina)
5007103
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

1005 Big Oak Ct

Knightdale, North Carolina 27545-6565

Phone: (919) 266-5669

Record Information

Enumeration Date
August 19, 2014
Provider's NPPES Record Last Updated
July 11, 2022
Certification Date
July 11, 2022
NPISignal NPPES Dataset
August 2026

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