Individual provider Active NPI

Darlene Johnson

  • Family Nurse Practitioner
  • Byhalia, MS
National Provider Identifier
1285233452
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904219 Issued in MS
Practice address
2808 Allyson Gene CV
Byhalia, MS 38611-7359
Phone
(901) 289-7903
NPI assigned
Oct 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 904219 MS Primary

Addresses

Primary practice location

2808 Allyson Gene CV
Byhalia, MS 38611-7359

Mailing address

2808 Allyson Gene CV
Byhalia, MS 38611-7359
Phone (901) 289-7903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20230125000730 MS Practitioner - Nurse Practitioner 3072984384 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904219MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hernando Family Medical Clinic, LLC Single Specialty Current Accepting new patients
Heartland Family Medical Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Desoto Family Care Clinic, PLLC Single Specialty CurrentSince Sep 23, 2024 Accepting new patients

Locations

131 Highway 309 S
Byhalia, MS 38611
Phone (662) 383-5565

346 Stateline Rd W
Southaven, MS 38671
Phone (662) 313-5417

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22832/brand/1/csg/1/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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1285233452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 ALLYSON GENE CV",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "386117359",
            "telephone_number": "901-289-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 ALLYSON GENE CV",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "386117359",
            "telephone_number": "901-289-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byhalia, MS

Sources for this page

Verify at the official NPI Registry.