Individual provider Active NPI

Marcie Leigh Johnson, APRN

  • Family Nurse Practitioner
  • Williamsburg, KY
National Provider Identifier
1194328831
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015451 Issued in KY
Practice address
686 S US-25W W
Williamsburg, KY 40769-1533
Phone
(606) 549-5052
Fax
(606) 549-2718
NPI assigned
Nov 17, 2020
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3015451 KY Primary

Addresses

Primary practice location

686 S US-25W W
Williamsburg, KY 40769-1533

Mailing address

55 Blanton Subdivision Rd
London, KY 40741-8256
Phone (606) 308-0905

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
I20210608002776 KY Practitioner - Nurse Practitioner 3678973906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Healthcare IncorporatedGroup PAC ID 5294990057, 2 clinicians

Practice addresses (Care Compare)

686 S Hwy 25 W
Williamsburg, KY 40769-1604
Phone (606) 549-5052

686 S Hwy 25W
Williamsburg, KY 40769-1604

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015451KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Urgent Care Walk-in Clinic CurrentSince Apr 5, 2023 Accepting new patients
Whitley Wellness Current Accepting new patients
Preferred Healthcare Incorporated CurrentSince Sep 18, 2023 Accepting new patients
Trinity Family Health Inc. Past Accepting new patients

Locations

241 Pasadena Dr
Ste 110
Lexington, KY 40503
Phone (859) 287-2627

686 S Highway 25 W
Williamsburg, KY 40769
Phone (606) 549-5052

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1194328831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BLANTON SUBDIVISION RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407418256",
            "telephone_number": "606-308-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 S US-25W W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691533",
            "telephone_number": "606-549-5052",
            "fax_number": "606-549-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARCIE",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

Verify at the official NPI Registry.