Individual provider Active NPI

Tashana Denise Johnson, CRNP

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1336577139
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014998 Issued in NC
Practice address
380 Knollwood St Ste 505
Winston Salem, NC 27103-1884
Phone
(833) 357-2966
NPI assigned
Oct 15, 2013
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R191917 MD
Family Nurse Practitioner 363LF0000X R191917 MD
Family Nurse Practitioner 363LF0000X 5014998 NC Primary

Addresses

Primary practice location

380 Knollwood St Ste 505
Winston Salem, NC 27103-1884

Mailing address

16031 Elizabeth Joyce Dr Apt 201
Charlotte, NC 28273-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140726000040 MD Practitioner - Nurse Practitioner 0840416962 Reassigns benefits to 1 organization
I20171011000646 DC Practitioner - Nurse Practitioner 0840416962 Reassigns benefits to 1 organization
I20210929001998 NC Practitioner - Nurse Practitioner 0840416962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

10490 Owings Mills Blvd
Owings Mills, MD 21117-7814
Phone (410) 363-7281

1505 E Churchville Rd
Bel Air, MD 21014-4742

2401 E Belvedere Ave
Baltimore, MD 21215-5216

3815 Wilkens Ave
Expresscare of Wilkens
Baltimore, MD 21229-5036
Phone (667) 212-5920

7700 Belair Rd
Baltimore, MD 21236-4004
Phone (410) 665-0670

7701 Harford Rd
Parkville, MD 21234-6403
Phone (410) 569-0069

8000 Loch Raven Blvd
Loch Raven, MD 21286-8337
Phone (410) 616-9027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5014998NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Exclusiv NP Concierge Current Accepting new patients
MNR Industries, LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Apr 1, 2024 Accepting new patients
MNR Industries, LLC CurrentSince Apr 1, 2024 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Apr 1, 2024 Accepting new patients
Summit Medical Group, PLLC PastSince Nov 21, 2022 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Interoperability endpoints

  • Direct secure messaging: tasjohnson@landmarkhealth-direct.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1336577139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16031 ELIZABETH JOYCE DR APT 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 KNOLLWOOD ST STE 505",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031884",
            "telephone_number": "833-357-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TASHANA",
        "middle_name": "DENISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-15",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R191917",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R191917",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.