Individual provider Active NPI

Stephanie M Johnson, APRN

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1255647061
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3006615 Issued in KY
Practice address
3900 Kresge Way Ste 56
Louisville, KY 40207-4683
Phone
(502) 895-7265
Fax
(502) 897-2032
NPI assigned
Aug 31, 2010
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3006615 KY Primary

Addresses

Primary practice location

3900 Kresge Way Ste 56
Louisville, KY 40207-4683

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4900

Other practice location 1

201 Abraham Flexner Way
Suite 1101
Louisville, KY 40202-3841
Phone (502) 581-1891

Other practice location 2

2400 Eastpoint Pkwy Ste 430
Louisville, KY 40223-4154
Phone (502) 253-6615

Other identifiers 1

IdentifierTypeStateIssuer
7100136300MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20101021000392 KY Practitioner - Nurse Practitioner 5294928370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

3900 Kresge Way
Suite 56
Louisville, KY 40207-4683
Phone (502) 895-7265

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3006615KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2015 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2015 Accepting new patients
University of Louisville Physicians, Inc. Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Apr 1, 2018 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Apr 1, 2018 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 1101
Louisville, KY 40202
Phone (502) 568-1455

2400 Eastpoint Pkwy
Ste 430
Louisville, KY 40223
Phone (502) 253-6615

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3900 Kresge Way
Ste 56
Louisville, KY 40207
Phone (502) 895-7265

401 E Chestnut St
Unit 510
Louisville, KY 40202
Phone (502) 588-4800

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

601 S Floyd St
Ste 500
Louisville, KY 40202
Phone (502) 458-6089

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.

Hospital & facility affiliations 1

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255647061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY STE 56",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074683",
            "telephone_number": "502-895-7265",
            "fax_number": "502-897-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Abraham Flexner Way",
            "address_2": "Suite 1101",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023841",
            "country_code": "US",
            "telephone_number": "502-581-1891",
            "fax_number": "502-540-5137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Eastpoint Pkwy Ste 430",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402234154",
            "country_code": "US",
            "telephone_number": "502-253-6615",
            "fax_number": "502-253-6615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100136300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.