Kellie Nicole Johnson, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

111063 Issued in NE

Practice address

1600 S 48TH St
Suite 600
Lincoln, NE 68506-1283

Phone

(402) 483-3333

Fax

(402) 483-3297

NPI assigned

Jul 22, 2009

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Cardiology Group LLCGroup PAC ID 7911803796, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

Merit-based Incentive Payment System (MIPS)

Final score

86.61 of 100Reported as group

Quality

87.74

Promoting interoperability

100

Improvement activities

40

Cost

67.62

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kjohnson13523@hisp.bryanhealth.org

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.

• Integrated Cardiology Group LLC

  • Cardiovascular Disease Physician
  • Lincoln, NE
  • NPI 1982653515
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1396975553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "address_2": "SUITE 600",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061283",
            "telephone_number": "402-483-3333",
            "fax_number": "402-483-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "address_2": "SUITE 600",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061283",
            "telephone_number": "402-483-3333",
            "fax_number": "402-483-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLIE",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "1845",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NE",
            "license": "111063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "1845  TEMP",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "63153",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "111063",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47084496100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel M Johnson, M.D.
• Justina Marie Johnson
• Kayla Marie Johnson
• Kayla Nevaeh Johnson
• Kaylynn Jo Johnson
• Kendra Johnson, LIMHP
• Kevin L Johnson, RP
• Kristy Johnson, DO
• Latrentis Zarnay Johnson
• Leah Johnson, OTD, OTR/L

• Adult Health Nurse Practitioner in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Adult Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.