Individual provider Active NPI

Laci Nicole Johnson, APRN, CNM, RDMS

  • Advanced Practice Midwife
  • Dallas, TX
National Provider Identifier
1174334080
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1000446 Issued in TX
Practice address
5750 Pineland Dr Ste 240
Dallas, TX 75231-5300
Phone
(214) 221-0855
Fax
(214) 221-1437
NPI assigned
Jan 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1000446 TX
Sonography Radiologic Technologist 2471S1302X 169948 TX
Vascular Sonography Radiologic Technologist 2471V0105X 169948 TX
Advanced Practice Midwife 367A00000X 1000446 TX Primary

Addresses

Primary practice location

5750 Pineland Dr Ste 240
Dallas, TX 75231-5300

Mailing address

5750 Pineland Dr Ste 240
Dallas, TX 75231-5300
Phone (214) 221-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5750 Pineland Dr
Suite 300
Dallas, TX 75231-9242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
169948TXMDVascular Sonography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Ministries Inc. PastSince Jan 1, 2025 Accepting new patients
Healing Hands Ministries Inc. PastSince Jan 1, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1174334080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 PINELAND DR STE 240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315300",
            "telephone_number": "214-221-0855",
            "fax_number": "214-221-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 PINELAND DR STE 240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315300",
            "telephone_number": "214-221-0855",
            "fax_number": "214-221-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LACI",
        "middle_name": "NICOLE",
        "credential": "APRN, CNM, RDMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1000446",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "TX",
            "license": "169948",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "TX",
            "license": "169948",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "1000446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.