Taisha Johnson, APRN, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11000891 Issued in FL

Practice address

1893 SW Kimberly Ave
Port St Lucie, FL 34953-1020

Phone

(772) 643-1645

NPI assigned

Jan 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pinnacle Home Care Home health agency, Port Saint Lucie, FL, CCN 109610

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• TJ Wellness, LLC

  • Primary Care Nurse Practitioner
  • Port St Lucie, FL
  • NPI 1275178188
  Medicare reassignment NPD Authorized official

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

• Pinnacle Home Care of the Palm Beaches, LLC.

  • Home Health Agency
  • Port St Lucie, FL
  • NPI 1285191825
  Care Compare affiliation

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1104381490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 SW KIMBERLY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531020",
            "telephone_number": "772-643-1645",
            "fax_number": "319-214-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 SW KIMBERLY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531020",
            "telephone_number": "772-643-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAISHA",
        "name_prefix": "Ms.",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11000891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janae Johnson, LCSW
• John W Johnson, RPT
• Kennethia Johnson
• Michelle Johnson, APRN
• Michelle Johnson
• Hillary Michelle Johnston
• Derwin Jones, LICENSED OPTICIAN
• Erica Jones
• Kerry Sullivan Jones
• Kevin A Jones, DDS

• Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.