Active NPI
Patsy Johnson, CFNP
- Family Nurse Practitioner
- Rolling Fork, MS
National Provider Identifier
1144245671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R559784
- Practice address
- 29 S Fourth St
Rolling Fork, MS 39159-5146 - Phone
- (662) 873-4361
- Fax
- (662) 873-2921
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R559784 | MS | Primary |
Addresses
Primary practice location
29 S Fourth St
Rolling Fork, MS 39159-5146
Mailing address
PO Box 520
Rolling Fork, MS 39159-0520
Phone (662) 873-4361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00118165 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R559784 | MS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144245671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 520",
"city": "ROLLING FORK",
"state": "MS",
"postal_code": "391590520",
"telephone_number": "662-873-4361",
"fax_number": "662-873-2921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 S FOURTH ST",
"city": "ROLLING FORK",
"state": "MS",
"postal_code": "391595146",
"telephone_number": "662-873-4361",
"fax_number": "662-873-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PATSY",
"name_prefix": "Mrs.",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R559784",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00118165",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rolling Fork, MS
- Martin Galas
- Andrew George, MD
- Jackson Rural Health Clinic P a
- Miriam Denise Jackson-Hamilton, LPC
- Danny Wade Jackson, D.O.
- Kinetix Medical Equipment, LLC
- Olivia Gayle King, PTA
- Mended Hearts Counseling Services, LLC
- Mississippi Christian Family Services Inc
- Mississippi Christian Family Services Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.