Individual provider Active NPI

Vinson Lewis Johnson, CRNP

  • Family Nurse Practitioner
  • Ozark, AL
National Provider Identifier
1093513715
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-180268 Issued in AL
Practice address
1519 Andrews Ave
Ozark, AL 36360-3719
Phone
(334) 774-7610
NPI assigned
Mar 6, 2025
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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 1-180268 AL Primary

Addresses

Primary practice location

1519 Andrews Ave
Ozark, AL 36360-3719

Mailing address

1519 Andrews Ave
Ozark, AL 36360-3719
Phone (334) 774-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20250717000743 AL Practitioner - Nurse Practitioner 0345755377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dale Medical CenterGroup PAC ID 3476466327, 29 clinicians

Practice addresses (Care Compare)

1519 Andrews Ave
Ozark, AL 36360-3719
Phone (334) 774-7610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-180268ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dale Medical Center CurrentSince May 1, 2025 Accepting new patients
Dale Medical Center Family CurrentSince May 1, 2025 Accepting new patients
Dale Medical Center Current Accepting new patients
Dale Medical Center Past Accepting new patients

Locations

1519 Andrews Ave
Ozark, AL 36360
Phone (334) 774-7610

Organizations & group practices 4

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.

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": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1093513715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 ANDREWS AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603719",
            "telephone_number": "334-774-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 ANDREWS AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603719",
            "telephone_number": "334-774-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VINSON",
        "middle_name": "LEWIS",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-180268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozark, AL

Sources for this page

Verify at the official NPI Registry.