Individual provider Active NPI

Maureen Lorraine Gay Johnson, CRNP

  • Adult Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1205167046
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP8969 Issued in AZ
Practice address
1982 W Main St Ste 101
Mesa, AZ 85201-6917
Phone
(480) 677-8282
Fax
(480) 535-0962
NPI assigned
Jan 19, 2010
Last updated
May 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP010677 PA
Adult Health Nurse Practitioner 363LA2200X AP8969 AZ Primary

Addresses

Primary practice location

1982 W Main St Ste 101
Mesa, AZ 85201-6917

Mailing address

517 N Ramunno Dr
Middletown, DE 19709-3047
Phone (215) 364-8412

Other practice location 1

1829 Bustleton Pike
Visiting Physicians of theDelaware Valley, LLC
Feasterville, PA 19053
Phone (215) 364-8412

Other names 1

  • Maureen L Gay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181008001414 AZ Practitioner - Nurse Practitioner 1254466501 Reassigns benefits to 2 organizations
I20221228000457 DE Practitioner - Nurse Practitioner 1254466501 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP010677PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince Aug 1, 2019 Accepting new patients
Good Health Medical, PLLC CurrentSince Aug 1, 2019 Accepting new patients
Good Health Medical, PLLC Current Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Dec 1, 2022 Accepting new patients
Judy Anderson, MD, PC Past Accepting new patients
Multicare Home Health Agency Inc PastSince Mar 22, 2020 Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

1982 W Main St
Ste 101
Mesa, AZ 85201
Phone (480) 295-4880

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

1209 N Orange St
Wilmington, DE 19801
Phone (800) 875-1575

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1205167046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N RAMUNNO DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197093047",
            "telephone_number": "215-364-8412",
            "fax_number": "215-364-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 W MAIN ST STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016917",
            "telephone_number": "480-677-8282",
            "fax_number": "480-535-0962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1829 Bustleton Pike",
            "address_2": "Visiting Physicians of theDelaware Valley, LLC",
            "address_purpose": "LOCATION",
            "city": "Feasterville",
            "state": "PA",
            "postal_code": "19053",
            "country_code": "US",
            "telephone_number": "215-364-8412",
            "fax_number": "215-364-8730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAY JOHNSON",
        "first_name": "MAUREEN",
        "middle_name": "LORRAINE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010677",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP8969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "GAY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.