Individual provider Active NPI

Rachel Lin Johnson, CPNP-PC

  • Pediatric Nurse Practitioner
  • Jamestown, NY
National Provider Identifier
1083219224
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383843 Issued in NY
Practice address
107 Institute St
Jamestown, NY 14701-6628
Phone
(716) 484-4334
NPI assigned
Dec 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383843 NY Primary

Addresses

Primary practice location

107 Institute St
Jamestown, NY 14701-6628

Mailing address

200 Chautauqua St
Fredonia, NY 14063-2240
Phone (716) 785-3149

Other practice location 1

1134 Central Ave
Dunkirk, NY 14048-3423
Phone (716) 366-6036

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
I20250822001873 NY Practitioner - Nurse Practitioner 3971003120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

107 Institute St
Jamestown, NY 14701-6628

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Chautauqua Center, Inc CurrentSince Aug 11, 2025 Accepting new patients
The Chautauqua Center, Inc CurrentSince Aug 11, 2025 Accepting new patients
Chautauqua PT OT & SLP Professionals PLLC Past Accepting new patients

Locations

1134 Central Ave
Dunkirk, NY 14048
Phone (716) 366-6036

107 Institute St
Jamestown, NY 14701
Phone (716) 484-4334

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22211/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1083219224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHAUTAUQUA ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140632240",
            "telephone_number": "716-785-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INSTITUTE ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016628",
            "telephone_number": "716-484-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "NY",
            "postal_code": "140483423",
            "country_code": "US",
            "telephone_number": "716-366-6036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RACHEL",
        "middle_name": "LIN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.