Mobile FNP Jrjohnson

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

MOBILE FNP JRJOHNSON

Practice address

236 N Mebane St Ste 123
Burlington, NC 27217-3900

Phone

(336) 639-7149

Fax

(336) 639-7141

NPI assigned

May 28, 2019

Organization subpart

No

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

Authorized official

Name

Julie Randolph Johnson, FNPNPI 1013300383

Title

Owner

Phone

(336) 639-7149

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 1

• Mobile FNP JR Johnson PLLC Doing business as

Electronic endpoints 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Randolph Johnson, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, NC
  • NPI 1013300383

  Multi-Specialty

  NPD Authorized official
• Patricia Marie Jimenez, CADC-R

  • Addiction (Substance Use Disorder) Counselor
  • Mayodan, NC
  • NPI 1427776848
  NPD (past)

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

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    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1194382945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 BROOKS RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273207579",
            "telephone_number": "336-639-7149",
            "fax_number": "336-639-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 N MEBANE ST STE 123",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272173900",
            "telephone_number": "336-639-7149",
            "fax_number": "336-639-7141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 N Franklin St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "NC",
            "postal_code": "270251916",
            "country_code": "US",
            "telephone_number": "336-612-1827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOBILE FNP JRJOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-639-7149",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
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            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
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            "license": null,
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        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
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        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
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        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013300383",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194382945",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://login.advancedmd.com/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "236 N Mebane St Ste 123",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272173900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Madison",
            "affiliation": "Y",
            "endpointDescription": "EHR",
            "affiliationName": "Mobile FNP JRJohnson",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "236 N Mebane St Ste 123",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272173900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Burlington",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "236 N Mebane St Ste 123",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272173900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mobile FNP JR Johnson PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mobile FNP JR Johnson PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ana Maria Miquel, CRNA
• Connie Jean Mitchell, LCMHC
• Samantha Mitchell, LCMHC
• Tori Cidiciqua Mitchell
• Jordan Mitchener
• Nikisha Michelle Mock
• Joel B. Moffett, M.D.
• Kristen S Moffitt, MD
• Mariah Jae Moger, PT, DPT
• Moher Family Care

• Addiction Medicine (Family Medicine) Physician in Burlington, NC
• Providers in Burlington, NC by specialty
• Addiction Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.