Dia Lynae Johnson, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R202400 Issued in MD

Practice address

4101 Glenhunt Rd
Baltimore, MD 21229-1705

Phone

(443) 558-8532

NPI assigned

Jan 14, 2019

Last updated

Oct 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Health Practice Partners LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Pasadena, MD
  • NPI 1407409253
  Medicare reassignment NPD
• Hands of Health Primary Care

  • Primary Care Nurse Practitioner
  • Baltimore, MD
  • NPI 1831703677
  Authorized official Same address or phone

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1386118289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 GLENHUNT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291705",
            "telephone_number": "443-558-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 GLENHUNT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291705",
            "telephone_number": "443-558-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DIA",
        "middle_name": "LYNAE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R202400",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R202400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deana Johnson, LCSW-C
• Deandre Pierre Johnson
• Deanna Johnson, PT
• Denise R Johnson
• Deora Kaye Johnson, DNP, CRNP
• Diane Laverne Johnson, RN
• Donna M Johnson
• Donnetta Johnson
• Donya Johnson
• Donye Johnson

• Gerontology Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Gerontology Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.