Individual provider Active NPI

Paula Johnson

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1063024677
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014687 Issued in NC
Practice address
612 College St
Jacksonville, NC 28540-5311
Phone
(910) 347-2154
Fax
(910) 347-5227
NPI assigned
Aug 17, 2020
Last updated
Dec 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5014687 NC
Family Nurse Practitioner 363LF0000X 5014687 NC Primary

Addresses

Primary practice location

612 College St
Jacksonville, NC 28540-5311

Mailing address

612 College St
Jacksonville, NC 28540-5311
Phone (910) 347-2154

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paula_johnson@onslowcountync.gov

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
I20211015000347 NC Practitioner - Nurse Practitioner 9234537697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OnslowGroup PAC ID 1355249343, 2 clinicians

Practice addresses (Care Compare)

612 College St
Jacksonville, NC 28540-5311
Phone (910) 347-2154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5014687NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Cape Fear Hospice, Inc CurrentSince Jul 1, 2024 Accepting new patients
County of Onslow CurrentSince Jul 1, 2024 Accepting new patients
County of Onslow Past Accepting new patients

Locations

612 College St
Jacksonville, NC 28540
Phone (910) 347-2154

Interoperability endpoints

  • Direct secure messaging: paula_johnson@onslowcountync.gov

Organizations & group practices 3

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1063024677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405311",
            "telephone_number": "910-347-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405311",
            "telephone_number": "910-347-2154",
            "fax_number": "910-347-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014687",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paula_johnson@onslowcountync.gov",
            "affiliation": "N",
            "address_1": "612 College St",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285405311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.