Individual provider Active NPI

Emily O'Bryan Johnson, ARNP

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1275836504
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6745P Issued in KY
Practice address
3198 Custer Dr Ste 100
Lexington, KY 40517-4074
Phone
(859) 231-6996
Fax
(866) 559-1302
NPI assigned
Dec 8, 2010
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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 6745P KY Primary

Addresses

Primary practice location

3198 Custer Dr Ste 100
Lexington, KY 40517-4074

Mailing address

3198 Custer Dr Ste 100
Lexington, KY 40517-4074
Phone (859) 231-6996

Other names 1

  • Emily O'Bryan Rogers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6745PKYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare Center LLC PastSince Mar 17, 2019 Accepting new patients
Madison Primary Care, LLC Family Past Accepting new patients
Lexington Primary Care LLC Family PastSince Jan 5, 2004 Accepting new patients

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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1275836504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 CUSTER DR STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174074",
            "telephone_number": "859-231-6996",
            "fax_number": "866-559-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3198 CUSTER DR STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174074",
            "telephone_number": "859-231-6996",
            "fax_number": "866-559-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "O'BRYAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "6745P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ROGERS",
            "middle_name": "O'BRYAN",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.