Individual provider Active NPI

Aida Faline Johnson, A.P.R.N, B.C.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Manassas, VA
National Provider Identifier
1255496808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
0015000771 Issued in VA
Practice address
9625 Surveyor CT
Manassas, VA 20110-4422
Phone
(703) 330-9933
NPI assigned
Dec 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0015000771 VA Primary

Addresses

Primary practice location

9625 Surveyor CT
Manassas, VA 20110-4422

Mailing address

9625 Surveyor Court
Manassas, VA 20110
Phone (703) 330-9933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240605002053 OR Practitioner - Nurse Practitioner 6507308574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Onepeak Southern Oregon PCGroup PAC ID 5395129670, 25 clinicians

Practice addresses (Care Compare)

3265 Hillcrest Park Dr
Medford, OR 97504-7657
Phone (541) 890-5217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0015000771VAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Onepeak Southern Oregon PC CurrentSince Mar 17, 2024 Accepting new patients
Prince William Family Counseling, P.C. Psychiatric/Mental Health, Adult Past Accepting new patients

Locations

3265 Hillcrest Park Dr
Medford, OR 97504
Phone (541) 275-6655

Interoperability endpoints

  • Direct secure messaging: aida.johnsonfmhpnpbci.p1@direct.opm.nextgenshare.com

Organizations & group practices 3

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255496808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR COURT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20110",
            "telephone_number": "703-330-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 SURVEYOR CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104422",
            "telephone_number": "703-330-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AIDA",
        "middle_name": "FALINE",
        "credential": "A.P.R.N, B.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0015000771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.