Individual provider Active NPI

Tayler M Johnston, DNP, CNM, WHNP

  • Advanced Practice Midwife
  • Jackson, TN
National Provider Identifier
1265966634
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
22511 Issued in TN
Practice address
72 Physicians Dr
Jackson, TN 38305
Phone
(731) 668-4455
NPI assigned
Apr 12, 2017
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 22511 TN
Advanced Practice Midwife 367A00000X 22511 TN Primary

Addresses

Primary practice location

72 Physicians Dr
Jackson, TN 38305

Mailing address

72 Physicians Dr
Jackson, TN 38305-2070
Phone (731) 668-4455

Other practice location 1

2110 Gladstone Ave
Nashville, TN 37211-2012
Phone (615) 835-3797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818003732 TN Practitioner - Certified Nurse Midwife (CNM) 2769808948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womans Clinic a Professional AssociationGroup PAC ID 1355308677, 15 clinicians

Practice addresses (Care Compare)

244 Coatsland Dr
Jackson, TN 38301-3948
Phone (731) 422-4642

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
22511TNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Womans Clinic a Professional Association CurrentSince Jul 1, 2020 Accepting new patients

Locations

244 Coatsland Dr
Jackson, TN 38301
Phone (731) 422-4642

Organizations & group practices 1

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1265966634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-668-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-668-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Gladstone Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372112012",
            "country_code": "US",
            "telephone_number": "615-835-3797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "TAYLER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DNP, CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "22511",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TN",
            "license": "22511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.