NPIMap

Individual provider Active NPI

Laura Jean Johnson, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1164986576
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1136964 Issued in KY
Practice address
5800 Bannon Crossings Dr
Louisville, KY 40228-1189
Phone
(502) 216-6140
NPI assigned
Jan 30, 2019
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28248284A IN
Family Nurse Practitioner 363LF0000X 1136964 KY Primary

Addresses

Primary practice location

5800 Bannon Crossings Dr
Louisville, KY 40228-1189

Mailing address

5800 Bannon Crossings Dr
Louisville, KY 40228-1189
Phone (502) 216-6140

Other identifiers 1

IdentifierTypeStateIssuer
300047339MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210927001129 KY Practitioner - Nurse Practitioner 1658778147 Reassigns benefits to 1 organization
I20251009003591 IN Practitioner - Nurse Practitioner 1658778147

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Institute PLLCGroup PAC ID 3779567706, 2 clinicians

Practice addresses (Care Compare)

3103 Breckenridge LN
Suite 1
Louisville, KY 40220-2798
Phone (502) 495-5055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28248284AINMDFamily Nurse Practitioner
1136964KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute PLLC CurrentSince Sep 8, 2021 Accepting new patients

Locations

3104 Blackiston Blvd
New Albany, IN 47150
Phone (502) 551-8305

3103 Breckenridge Ln
Ste 1
Louisville, KY 40220
Phone (502) 495-5055

Organizations & group practices 1

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1164986576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 BANNON CROSSINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402281189",
            "telephone_number": "502-216-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 BANNON CROSSINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402281189",
            "telephone_number": "502-216-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28248284A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "1136964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300047339",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.