Individual provider Active NPI

Aaron Ross Johnston, FNP

  • Family Nurse Practitioner
  • Ft. Campbell, KY
National Provider Identifier
1306074299
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN000017882 Issued in TN
Practice address
650 Joel Dr.
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349
Phone
(270) 798-8130
Fax
(270) 956-0180
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN1901129 GA
Family Nurse Practitioner 363LF0000X APN000017882 TN Primary

Addresses

Primary practice location

650 Joel Dr.
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349

Mailing address

650 Joel Dr.
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223-5349
Phone (270) 798-8130

Other identifiers 1

IdentifierTypeStateIssuer
VAD000OtherKYVAD000

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140619002307 TN Practitioner - Nurse Practitioner 9436373123 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN1901129GAMDFamily Nurse Practitioner
APN000017882TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Spine & Physical Medicine, PC CurrentSince May 1, 2014 Accepting new patients

Locations

121 W Dunbar Cave Rd
Clarksville, TN 37040
Phone (931) 542-5420

625 N Riverside Dr
Clarksville, TN 37040
Phone (931) 542-5420

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1306074299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR.",
            "address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "city": "FT. CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8130",
            "fax_number": "270-956-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR.",
            "address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "city": "FT. CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8130",
            "fax_number": "270-956-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "AARON",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN1901129",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN000017882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VAD000",
            "identifier": "VAD000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Campbell, KY

Sources for this page

Verify at the official NPI Registry.