Individual provider Active NPI

Amber Camille Johnson, CNS

  • Gerontology Clinical Nurse Specialist
  • Jacksonville, FL
National Provider Identifier
1093424616
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
APRN11012587 Issued in FL
Practice address
8283 Baymeadows Rd E Apt 1301
Jacksonville, FL 32256-3060
Phone
(313) 595-8609
NPI assigned
Nov 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X APRN11012587 FL Primary

Addresses

Primary practice location

8283 Baymeadows Rd E Apt 1301
Jacksonville, FL 32256-3060

Mailing address

8283 Baymeadows Rd E Apt 1301
Jacksonville, FL 32256-3060
Phone (313) 595-8609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
APRN11012587FLMDGerontology Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1093424616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8283 BAYMEADOWS RD E APT 1301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563060",
            "telephone_number": "313-595-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8283 BAYMEADOWS RD E APT 1301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563060",
            "telephone_number": "313-595-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMBER",
        "middle_name": "CAMILLE",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "FL",
            "license": "APRN11012587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.