Individual provider Active NPI

Carrie Lynn Johnson, MD

  • Obstetrics & Gynecology Physician
  • Lakeland, FL
National Provider Identifier
1174525091
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME102875 Issued in FL
Practice address
1733 Lakeland Hills Blvd
Lakeland, FL 33805-3016
Phone
(813) 286-0033
Fax
(813) 282-1806
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD189072 OR
Obstetrics & Gynecology Physician 207V00000X ME102875 FL Primary
Obstetrics & Gynecology Physician 207V00000X MD61550112 WA
Obstetrics & Gynecology Physician 207V00000X 036090783 IL

Addresses

Primary practice location

1733 Lakeland Hills Blvd
Lakeland, FL 33805-3016

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

1350 Hickory St
Melbourne, FL 32901-3224
Phone (407) 975-0406

Other practice location 2

505 NE 87th Ave Ste 160
Vancouver, WA 98664-1965
Phone (360) 514-1060

Other practice location 3

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

Other identifiers 3

IdentifierTypeStateIssuer
008052600MedicaidFL
3025372MedicaidOH
119355500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjohnson188525@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090630000431 FL Practitioner - Obstetrics/Gynecology 9931173069 Reassigns benefits to 5 organizations
I20240725002024 AR Practitioner - Obstetrics/Gynecology 9931173069 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036090783ILMDObstetrics & Gynecology Physician
MD61550112WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 1, 2017 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Arkansas Health Group CurrentSince Jul 1, 2024 Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
Lee Health System Inc Obstetrics & Gynecology CurrentSince Feb 17, 2025 Accepting new patients
DHP of Arkansas PA Obstetrics & Gynecology CurrentSince Dec 12, 2024 Accepting new patients
Community Health of South Florida, Inc CurrentSince Jun 18, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 1, 2017 Accepting new patients
Arkansas Health Group CurrentSince Jul 1, 2024 Accepting new patients
Community Health of South Florida Inc CurrentSince Jun 18, 2020 Accepting new patients
Lee Health System Inc CurrentSince Feb 17, 2025 Accepting new patients
University of Miami Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 4, 2021 Accepting new patients
Florida Hospital Medical Group Inc Obstetrics & Gynecology CurrentSince Jan 4, 2021 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Past Accepting new patients
Endeavor Health Medical Group Past Accepting new patients

Locations

9501 Baptist Health Dr
Ste 800
Little Rock, AR 72205
Phone (501) 223-2080

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

10300 SW 216th St
Cutler Bay, FL 33190

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1321 NW 14th St
Ste 201
Miami, FL 33125
Phone (305) 243-4551

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

1321 NW 14th St
Miami, FL 33125
Phone (305) 689-5464

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Networks

  • Freedom Health HMO Network

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1174525091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053016",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "407-975-0406",
            "fax_number": "407-975-0407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 NE 87th Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-1060",
            "fax_number": "360-514-1065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1138 Country Club Blvd",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339903027",
            "country_code": "US",
            "telephone_number": "239-424-1900",
            "fax_number": "239-424-1904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD189072",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME102875",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD61550112",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036090783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008052600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119355500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjohnson188525@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St Ste B",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.