Jacqueline Johnson, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP143029 Issued in TX

Practice address

1501 Biscayne Blvd
Miami, FL 33132-1449

Phone

(887) 787-0032

Fax

(866) 427-3798

NPI assigned

Nov 27, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MS, CA, FL, OH5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.johnson@237407481626628.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Hermann Medical Group

  • Family Medicine Physician
  • Fulshear, TX
  • NPI 1003985102
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169

  Nurse Practitioner

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MS, Nurse Practitioner, OH

  Medicare reassignment NPD
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  TX

  Medicare reassignment
• Pallicare, Inc

  • Community Health Nurse Practitioner
  • Texarkana, TX
  • NPI 1316511884
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  FL

  Medicare reassignment
• Ig Health and Wellness

  • Clinic/Center
  • Pembroke Pines, FL
  • NPI 1245017623
  NPD (past)
• Fast Doc LLC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1174307854
  NPD (past)
• Self Wellness & Health

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1902578479
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1003359951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W RUTHERFORD ST",
            "city": "MOUNT VERNON",
            "state": "TX",
            "postal_code": "754573253",
            "telephone_number": "501-539-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331321449",
            "telephone_number": "887-787-0032",
            "fax_number": "866-427-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACQUELINE",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-27",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "81-4360797",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP143029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Louise Johnson
• Elizabeth Renee Johnson, M.D.
• Gail Johnson
• Gail Mary Johnson, RPT
• Ilya Simone Johnson, M.D.
• John Johnson
• John Jefferson Johnson V, LAT, ATC
• Jonique Johnson, PHARMD, RPH, MTM
• Joshua Lynn Johnson
• Kathryn Johnson, RN

• Gerontology Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.