Individual provider Active NPI

Karen L Johnson, ARNP

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1417090523
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2623012 Issued in FL
Practice address
12450 Roosevelt Blvd N Ste 101
St Petersburg, FL 33716-1902
Phone
(727) 571-1688
Fax
(727) 561-0674
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP2623012 FL
Family Nurse Practitioner 363LF0000X 2623012 FL Primary

Addresses

Primary practice location

12450 Roosevelt Blvd N Ste 101
St Petersburg, FL 33716-1902

Mailing address

1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 322-1054

Other identifiers 1

IdentifierTypeStateIssuer
002122800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071114000018 FL Practitioner - Nurse Practitioner 7416045117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast Primary Care LLCGroup PAC ID 6709041585, 4 clinicians

Practice addresses (Care Compare)

12450 Roosevelt Blvd N
Suite 101
St Petersburg, FL 33716-1902
Phone (727) 571-1688

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2623012FLMDFamily Nurse Practitioner
ARNP2623012FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Feb 19, 2018 Accepting new patients
West Coast Primary Care, LLC CurrentSince Oct 1, 2012 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Feb 19, 2018 Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
SC Physicians LLC PastSince Oct 1, 2012 Accepting new patients

Locations

12450 Roosevelt Blvd N
Ste 101
St Petersburg, FL 33716
Phone (727) 571-1688

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

601 7th St S
St Petersburg, FL 33701
Phone (727) 572-0900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIGJBA

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1417090523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 ROOSEVELT BLVD N STE 101",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161902",
            "telephone_number": "727-571-1688",
            "fax_number": "727-561-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2623012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2623012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002122800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.