Individual provider Active NPI

Twyla Johnson, APRN

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1174529374
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3003938 Issued in KY
Practice address
1325 Andrea St
Bowling Green, KY 42104-5852
Phone
(270) 783-3323
Fax
(270) 781-0566
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3003938 KY Primary

Addresses

Primary practice location

1325 Andrea St
Bowling Green, KY 42104-5852

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 783-3323

Other identifiers 1

IdentifierTypeStateIssuer
78013679MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20050207000282 KY Practitioner - Nurse Practitioner 1153372248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3003938KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jul 1, 2016 Accepting new patients
Graves Gilbert Clinic PLLC Nurse Practitioner CurrentSince Jul 1, 2016 Accepting new patients

Locations

484 Golden Autumn Way
Ste 201
Bowling Green, KY 42103
Phone (270) 783-3300

1325 Andrea St
Bowling Green, KY 42104
Phone (270) 783-3323

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: twylajohnson@ggc.allscriptsdirect.net

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1174529374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-783-3323",
            "fax_number": "270-781-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANDREA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045852",
            "telephone_number": "270-783-3323",
            "fax_number": "270-781-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TWYLA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3003938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78013679",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.