Individual provider Active NPI

Emily Louise Johnson

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1033997382
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5018834 Issued in NC
Practice address
1215 W Clemmonsville Rd
Winston Salem, NC 27127-4521
Phone
(336) 300-8855
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5018834 NC Primary

Addresses

Primary practice location

1215 W Clemmonsville Rd
Winston Salem, NC 27127-4521

Mailing address

104 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 224-0931

Other practice location 1

104 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 224-0931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20231123000116 NC Practitioner - Nurse Practitioner 3274981667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Rock Internal Medicine PAGroup PAC ID 0143246439, 4 clinicians

Practice addresses (Care Compare)

104 W Medical Park Dr
Lexington, NC 27292-6773
Phone (336) 224-0931

Hospital & facility affiliations

  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Rock Internal Medicine, PA CurrentSince Oct 2, 2023 Accepting new patients
High Rock Internal Medicine CurrentSince Oct 2, 2023 Accepting new patients

Locations

104 W Medical Park Dr
Lexington, NC 27292
Phone (336) 224-0931

1215 W Clemmonsville Rd
Ste C
Winston Salem, NC 27127
Phone 3362240931 ext. 313

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1033997382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W MEDICAL PARK DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926773",
            "telephone_number": "336-224-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W CLEMMONSVILLE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271274521",
            "telephone_number": "336-300-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 W Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272926773",
            "country_code": "US",
            "telephone_number": "336-224-0931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.