Individual provider Active NPI

Renee Johnson

  • Psychiatric/Mental Health Nurse Practitioner
  • Athens, GA
National Provider Identifier
1023867785
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407505 Issued in NY
Practice address
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone
(706) 389-6789
NPI assigned
May 15, 2024
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407505 NY Primary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 2025040897 GA
Registered Nurse 163W00000X RN259072 GA

Addresses

Primary practice location

240 Mitchell Bridge Rd
Athens, GA 30606-2043

Mailing address

2245 Ewell Park Dr
Lawrenceville, GA 30043-1708
Phone (404) 932-4148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251210003537 NY Practitioner - Nurse Practitioner 8022502772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2245 Ewell Park Dr
Lawrenceville, GA 30043-1708

80 5TH Ave
Suite 903 10
New York, NY 10011-8020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN259072GAMDRegistered Nurse
407505NYMDPsychiatric/Mental Health Nurse Practitioner
2025040897GAMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orenda Psychiatry PLLC Single Specialty CurrentSince Dec 3, 2025 Accepting new patients

Locations

80 5th Ave
New York, NY 10011
Phone (646) 460-0097

80 5th Ave
Ste 90310
New York, NY 10011

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1023867785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 EWELL PARK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300431708",
            "telephone_number": "404-932-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MITCHELL BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062043",
            "telephone_number": "706-389-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407505",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "GA",
            "license": "2025040897",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN259072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.