Individual provider Active NPI

Johanna Lynn Stith, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1225514060
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11024069 Issued in FL
Practice address
439 SW Michigan St
Lake City, FL 32025-0440
Phone
(386) 487-0800
Fax
(352) 565-1044
NPI assigned
Jul 16, 2018
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11024069 FL Primary
Registered Nurse 163W00000X RN9486897 FL

Addresses

Primary practice location

439 SW Michigan St
Lake City, FL 32025-0440

Mailing address

439 SW Michigan St
Lake City, FL 32025-0440
Phone (386) 487-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230412002748 FL Practitioner - Nurse Practitioner 9931574506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1549 SW 13TH St
Gainesville, FL 32608-1113
Phone (352) 374-5600

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone 35237456008210

4310 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

4316 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9486897FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Behavioral Healthcare, Inc. CurrentSince Mar 14, 2023 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince Mar 14, 2023 Accepting new patients
Live Oak Hma Medical Group, LLC Current Accepting new patients
Quality Neurology LLC CurrentSince Jan 23, 2023 Accepting new patients

Locations

4300 SW 13th St
Gainesville, FL 32608

6800 NW 9th Blvd
Ste 2
Gainesville, FL 32605
Phone (352) 332-7990

1717 SW Newland Way
Lake City, FL 32025
Phone (352) 478-4700

439 SW Michigan St
Lake City, FL 32025
Phone (386) 487-0800

920 Nobles Ferry Rd
Live Oak, FL 32064
Phone (386) 339-4010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFGACD

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.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1225514060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 SW MICHIGAN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250440",
            "telephone_number": "386-487-0800",
            "fax_number": "352-565-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 SW MICHIGAN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250440",
            "telephone_number": "386-487-0800",
            "fax_number": "352-565-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITH",
        "first_name": "JOHANNA",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11024069",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9486897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.