Individual provider Active NPI

Denise Johnson, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1407242795
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1134759 Issued in AL
Practice address
4200 Chris Dr SW
#100
Huntsville, AL 35802-4197
Phone
(256) 880-1101
NPI assigned
Apr 13, 2015
Last updated
May 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1134759 AL Primary

Addresses

Primary practice location

4200 Chris Dr SW
#100
Huntsville, AL 35802-4197

Mailing address

645 Wynn Dr NW Unit 5892
Huntsville, AL 35814-6038
Phone (347) 683-8141

Other practice location 1

2373 Roberts Ln
Florence, AL 35630-1296
Phone (256) 760-0442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150701002293 AL Practitioner - Nurse Practitioner 1658683727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Huntsville, AL 35810
Phone (866) 220-3383

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1134759ALMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1407242795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 WYNN DR NW UNIT 5892",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358146038",
            "telephone_number": "347-683-8141",
            "fax_number": "866-445-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 CHRIS DR SW",
            "address_2": "#100",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024197",
            "telephone_number": "256-880-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2373 Roberts Ln",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356301296",
            "country_code": "US",
            "telephone_number": "256-760-0442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1134759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.