Individual provider Active NPI

Kaye-Loni Nichole Johnson, APRN

  • Family Medicine Physician
  • Middletown, CT
National Provider Identifier
1407767254
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18409 Issued in CT
Practice address
915 River Rd
Middletown, CT 06457-3921
Phone
(860) 704-4056
NPI assigned
Sep 12, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 212234 CT
Family Medicine Physician 207Q00000X 18409 CT Primary

Addresses

Primary practice location

915 River Rd
Middletown, CT 06457-3921

Mailing address

915 River Rd
Middletown, CT 06457-3921
Phone (860) 704-4056

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

NPI Registry JSON

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

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1407767254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 RIVER RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573921",
            "telephone_number": "860-704-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 RIVER RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573921",
            "telephone_number": "860-704-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAYE-LONI",
        "middle_name": "NICHOLE",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CT",
            "license": "212234",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "18409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.