Individual provider Active NPI

Alice Johnson, FNP

  • Family Nurse Practitioner
  • Geneva, NY
National Provider Identifier
1326102500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F330480 Issued in NY
Practice address
200 North St
Suite 101
Geneva, NY 14456-1561
Phone
(315) 787-5100
Fax
(315) 787-5108
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 F330480 NY Primary

Addresses

Primary practice location

200 North St
Suite 101
Geneva, NY 14456-1561

Mailing address

200 North St
Suite 101
Geneva, NY 14456-1561
Phone (315) 787-5100

Other identifiers 4

IdentifierTypeStateIssuer
P00003445OtherNYR.R. MEDICARE
01235432MedicaidNY
109570BJOtherNYPREFERRED CARE
P019330480OtherNYBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101020000714 NY Practitioner - Nurse Practitioner 7618160805 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F330480NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Sep 1, 2015 Accepting new patients
Finger Lakes Area Counseling and Recovery Agency, Inc. CurrentSince Sep 17, 2019 Accepting new patients

Locations

28 E Main St
Clifton Springs, NY 14432
Phone (315) 462-9466

200 North St
Ste 101
Geneva, NY 14456
Phone (315) 787-5100

339 East Ave
Ste 303
Rochester, NY 14604
Phone (315) 462-9466

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 2

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326102500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 101",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5100",
            "fax_number": "315-787-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 101",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5100",
            "fax_number": "315-787-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALICE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "P00003445",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01235432",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "109570BJ",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019330480",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.