Individual provider Active NPI

Kellee Johnson, APRN, FNP, BSN, RN

  • Family Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1255832630
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012062 Issued in KY
Practice address
2201 Lexington Ave
Ashland, KY 41101-2843
Phone
(606) 408-4000
NPI assigned
Feb 22, 2018
Last updated
Feb 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3012062 KY Primary
Registered Nurse 163W00000X 99113 WV
Registered Nurse 163W00000X 391374 OH
Registered Nurse 163W00000X 1074151 KY

Addresses

Primary practice location

2201 Lexington Ave
Ashland, KY 41101-2843

Mailing address

2201 Lexington Ave
Ashland, KY 41101-2843

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
I20180419000532 KY Practitioner - Nurse Practitioner 7416210984 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1074151KYMDRegistered Nurse
391374OHMDRegistered Nurse
99113WVMDRegistered Nurse
3012062KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Institute of Western Kentucky PLLC CurrentSince Jun 1, 2022 Accepting new patients
Ashland Family Medicine Past Accepting new patients
Dr. Melissa Davis, P.S.C. Past Accepting new patients

Locations

200 Clint Hill Blvd
Paducah, KY 42001
Phone (270) 442-9461

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1255832630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLEE",
        "credential": "APRN, FNP, BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012062",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "99113",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "391374",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1074151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.