Individual provider Active NPI

Mildred Maria Johnson, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1326682188
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004098 Issued in FL
Practice address
1300 W Oak St
Kissimmee, FL 34741-4024
Phone
(407) 944-5240
Fax
(407) 944-5251
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 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 Practitioner 363LF0000X APRN11004098 FL Primary

Addresses

Primary practice location

1300 W Oak St
Kissimmee, FL 34741-4024

Mailing address

1300 W Oak St
Kissimmee, FL 34741-4024
Phone (407) 944-5240

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
I20200306000752 FL Practitioner - Nurse Practitioner 4385072271 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11004098FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 2, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 2, 2020 Accepting new patients

Locations

400 Celebration Pl
Ste A270
Kissimmee, FL 34747
Phone (407) 303-4078

1300 W Oak St
Kissimmee, FL 34741
Phone (407) 944-5201

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: mjohnson74010@adventhealth.direct-ci.com

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1326682188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414024",
            "telephone_number": "407-944-5240",
            "fax_number": "407-944-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414024",
            "telephone_number": "407-944-5240",
            "fax_number": "407-944-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MILDRED",
        "middle_name": "MARIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.