Individual provider Active NPI

Celestine D Johnson-Gardner

  • Family Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1255083911
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180947 Issued in VA
Practice address
142 W York St Ste 905
Norfolk, VA 23510-2015
Phone
(757) 623-3038
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024180947 VA Primary

Addresses

Primary practice location

142 W York St Ste 905
Norfolk, VA 23510-2015

Mailing address

142 W York St Ste 905
Norfolk, VA 23510-2015
Phone (757) 623-3038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AL2 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
I20260203000224 VA Practitioner - Nurse Practitioner 6103304985 Reassigns benefits to 1 organization
I20260309000431 AL Practitioner - Nurse Practitioner 6103304985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Dallas, TX 75244-4910

4055 Valley View LN
Suite 400
Dallas, TX 75244-5071

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024180947VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
Charles F. Lovell, Jr., M.D., Facp, P.C. PastSince Feb 1, 2022 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

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

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

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.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1255083911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 W YORK ST STE 905",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102015",
            "telephone_number": "757-623-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W YORK ST STE 905",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102015",
            "telephone_number": "757-623-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-GARDNER",
        "first_name": "CELESTINE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.