Individual provider Active NPI

Erik Ian Johnson

  • Acute Care Clinical Nurse Specialist
  • Oviedo, FL
National Provider Identifier
1346094489
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
11031651 Issued in FL
Practice address
1023 Kelly Creek Cir
Oviedo, FL 32765-5703
Phone
(719) 761-5677
NPI assigned
Apr 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 11031651 FL Primary

Addresses

Primary practice location

1023 Kelly Creek Cir
Oviedo, FL 32765-5703

Mailing address

1023 Kelly Creek Cir
Oviedo, FL 32765-5703
Phone (719) 761-5677

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
I20240506001557 FL Practitioner - Nurse Practitioner 2668812769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Vision LLCGroup PAC ID 9032349733, 66 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (904) 231-1204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031651FLMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince Mar 24, 2024 Accepting new patients

Locations

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

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": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1346094489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 KELLY CREEK CIR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655703",
            "telephone_number": "719-761-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 KELLY CREEK CIR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655703",
            "telephone_number": "719-761-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIK",
        "middle_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "FL",
            "license": "11031651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.