Individual provider Active NPI

Krista Johnson, APRN

  • Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1316265994
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9259102 Issued in FL
Practice address
2398 SE Ocean Blvd Ste a
Stuart, FL 34996-3310
Phone
(772) 419-4834
Fax
(772) 419-4833
NPI assigned
May 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9259102 FL
Nurse Practitioner 363L00000X APRN9259102 FL Primary

Addresses

Primary practice location

2398 SE Ocean Blvd Ste a
Stuart, FL 34996-3310

Mailing address

260 NW Peacock Blvd Ste 102
Port St Lucie, FL 34986-2349
Phone (772) 878-7216

Other practice location 1

450 SW Exmore Ave
Port St Lucie, FL 34983-2815
Phone (772) 879-2127

Other names 1

  • Krista Lipson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110328000436 FL Practitioner - Nurse Practitioner 3173706264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Florida Psychiatry Associates LLCGroup PAC ID 0345404166, 6 clinicians

Practice addresses (Care Compare)

260 NW Peacock Blvd
Suite 102
Port Saint Lucie, FL 34986-2349
Phone (772) 878-7216

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9259102FLMDPsychiatric/Mental Health Nurse Practitioner

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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1316265994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NW PEACOCK BLVD STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862349",
            "telephone_number": "772-878-7216",
            "fax_number": "772-878-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2398 SE OCEAN BLVD STE A",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963310",
            "telephone_number": "772-419-4834",
            "fax_number": "772-419-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 SW Exmore Ave",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349832815",
            "country_code": "US",
            "telephone_number": "772-879-2127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9259102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9259102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "LIPSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.