Callie Johnson, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5021438 Issued in NC

Practice address

3681 N Main St
Farmville, NC 27828-1464

Phone

(252) 753-7141

NPI assigned

Jan 6, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Physicians East PAGroup PAC ID 1850284571, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: calliejohnson@pepa.medalliesdirect.net

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.

• Physicians East, P.a.

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1598761967
  Medicare reassignment Care Compare group NPD
• Physicians East, PA

  • Obstetrics & Gynecology Physician
  • Greenville, NC
  • NPI 1205884939
  NPD
• Physicians East PA

  • Multi-Specialty Clinic/Center
  • Farmville, NC
  • NPI 1033115407
  NPD (past)

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1194534081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3681 N MAIN ST",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281464",
            "telephone_number": "252-753-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 N MAIN ST",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281464",
            "telephone_number": "252-753-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CALLIE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021438",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5021438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jody Lynn Holtz, FNP-C
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• Logan Kennedy, LAT, ATC
• Key to Kindness Adult Care
• Christina Kidd, NP-C
• Kimyatta Anderson

• Nurse Practitioner in Farmville, NC
• Providers in Farmville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.