Individual provider Active NPI

Devyn Alaisea-Rookh Johnson

  • Family Nurse Practitioner
  • Kenly, NC
National Provider Identifier
1245079268
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5022832 Issued in NC
Practice address
101 E 2ND St
Kenly, NC 27542-7794
Phone
(919) 284-4025
Fax
(919) 284-5965
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 5022832 NC Primary

Addresses

Primary practice location

101 E 2ND St
Kenly, NC 27542-7794

Mailing address

120 N Medical Drive Unc-CH-Son
Chapel Hill, NC 27599-0001
Phone (919) 966-4260

Other practice location 1

120 N Medical Drive Unc-Ch-Son
Chapel Hill, NC 27599-0001
Phone (919) 966-4260

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250927000270 NC Practitioner - Nurse Practitioner 5991200024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenly Medical Associates PAGroup PAC ID 2567657448, 2 clinicians

Practice addresses (Care Compare)

101 E 2ND St
Kenly, NC 27542-7794
Phone (919) 284-4025

Hospital & facility affiliations

  • Johnston Health Hospital, Smithfield, NC, CCN 340090
  • Wilson Medical Center Hospital, Wilson, NC, CCN 340126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5022832NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kenly Medical Associates, PA CurrentSince Aug 25, 2025 Accepting new patients
Wilson Family Practice Center Inc PastSince Nov 24, 2025 Accepting new patients

Locations

101 E 2nd St
Kenly, NC 27542
Phone (919) 249-5652

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1245079268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL DRIVE UNC-CH-SON",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-966-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 2ND ST",
            "city": "KENLY",
            "state": "NC",
            "postal_code": "275427794",
            "telephone_number": "919-284-4025",
            "fax_number": "919-284-5965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 N Medical Drive Unc-Ch-Son",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEVYN",
        "middle_name": "ALAISEA-ROOKH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5022832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenly, NC

Sources for this page

Verify at the official NPI Registry.