Tiesha D Johnson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401131 Issued in NY

Practice address

1676 Sunset Ave
Utica, NY 13502-5416

Phone

(315) 624-4801

Fax

(315) 624-5401

NPI assigned

Aug 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, NY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MVHS Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment Care Compare group NPD
• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment NPD
• MVHS Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Nationwide Children'S Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1104082346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "address_2": "ATTN: CREDENTIALING DEPT",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-801-8534",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025416",
            "telephone_number": "315-624-4801",
            "fax_number": "315-624-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052639",
            "country_code": "US",
            "telephone_number": "614-722-4545",
            "fax_number": "614-722-4575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432153427",
            "country_code": "US",
            "telephone_number": "614-938-0167",
            "fax_number": "614-938-0170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIESHA",
        "middle_name": "D",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401131",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.024042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0384373",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Johnson
• Heather M Johnson, LPN
• Leah Johnson
• Nancy A Johnson, LCSW
• Rita Johnson, PT
• Michelle M Johnston, MD
• Surendra K. Johri, MD
• Kathleen Bridget Joly, M.S., RPA-C
• Allison Jones
• Cynthia L Jones, MD, MPH

• Psychiatric/Mental Health Nurse Practitioner in Utica, NY
• Providers in Utica, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.