Individual provider Active NPI

Stephanie Michele Johnson, FNP-C

  • Family Nurse Practitioner
  • Annandale, VA
National Provider Identifier
1376062406
Registry record updated Nov 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175159 Issued in VA
Practice address
7805 Byrds Nest Pass
Annandale, VA 22003-1544
Phone
(908) 304-2681
NPI assigned
Sep 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R207751 MD
Family Nurse Practitioner 363LF0000X 0024175159 VA Primary
Nurse Practitioner 363L00000X RN1031302 DC

Addresses

Primary practice location

7805 Byrds Nest Pass
Annandale, VA 22003-1544

Mailing address

7805 Byrds Nest Pass
Annandale, VA 22003-1544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN1031302DCMDNurse Practitioner
R207751MDMDFamily Nurse Practitioner
0024175159VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Watergate and Burke Allergy & Asthma Centers, PLLC PastSince Jun 6, 2021 Accepting new patients

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": "1504915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762041600000",
    "number": "1376062406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7805 BYRDS NEST PASS",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7805 BYRDS NEST PASS",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031544",
            "telephone_number": "908-304-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-09",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R207751",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175159",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1031302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.