David Lars Christian Johnsrud, BA, MAC, BSN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RNP289863 Issued in AZ

Practice address

1002 15TH St SW
Mailstop 1002-1-Tri
Auburn, WA 98001-9841

Phone

(520) 225-9785

NPI assigned

Mar 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Karen Christiane Johnsrude Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

84.24 of 100Reported as group

Quality

71.1

Promoting interoperability

68

Improvement activities

40

Cost

69.7

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Bachelor on Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1063152791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 N COUNTRY CLUB RD UNIT 2",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161011",
            "telephone_number": "520-225-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 15TH ST SW",
            "address_2": "MAILSTOP 1002-1-TRI",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980019841",
            "telephone_number": "520-225-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSRUD",
        "first_name": "DAVID",
        "middle_name": "LARS CHRISTIAN",
        "name_prefix": "Mr.",
        "credential": "BA, MAC, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "WA",
            "license": "60607354",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RNP289863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "JOHNSRUDE",
            "middle_name": "CHRISTIANE",
            "credential": "BA, MAC, BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marissa Lynn Johnson, MSW
• Melissa Hazel Johnson, L.M.P.
• Michael Johnson
• Tracy Johnson
• Vickie Jo Johnson
• Carissa K Johnston
• Grace Ann Johnston, ASN, RN
• Caroline Fraser Jolley, MD
• Bradley J Jones, PT
• Cindra Ann Jones, LMHCA CDPT

• Psychiatric/Mental Health Nurse Practitioner in Auburn, WA
• Providers in Auburn, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.