NPIMap

Individual provider Active NPI

Katherina K Johnson, NP-C

  • Nurse Practitioner
  • Rutherfordton, NC
National Provider Identifier
1427720655
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015168 Issued in NC
Practice address
128 Dr Henry Norris Dr
Rutherfordton, NC 28139-3165
Phone
(828) 286-5575
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015168 NC Primary

Addresses

Primary practice location

128 Dr Henry Norris Dr
Rutherfordton, NC 28139-3165

Mailing address

16 Windsong Dr
Fairview, NC 28730-9700
Phone (828) 443-7022

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Rutherfordton

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026002056 NC Practitioner - Nurse Practitioner 0143618033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Frye Medical Group LLCGroup PAC ID 8123397601, 125 clinicians

Practice addresses (Care Compare)

2660 Tate Blvd SE
Hickory, NC 28602-1465
Phone (828) 261-0009

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015168NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC Nurse Practitioner CurrentSince Dec 1, 2024 Accepting new patients
DLP Frye Medical Group LLC CurrentSince Dec 1, 2024 Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Nov 14, 2021 Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Nov 14, 2021 Accepting new patients
DLP Rutherford Physician Practices LLC Past Accepting new patients

Locations

2660 Tate Blvd SE
Hickory, NC 28602
Phone (828) 261-0009

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

128 Dr Henry Norris Dr
Rutherfordton, NC 28139
Phone (828) 286-3479

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: katherina.johnson.1@15786.direct.athenahealth.com

Organizations & group practices 5

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": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1427720655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WINDSONG DR",
            "city": "FAIRVIEW",
            "state": "NC",
            "postal_code": "287309700",
            "telephone_number": "828-443-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 DR HENRY NORRIS DR",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281393165",
            "telephone_number": "828-286-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINA",
        "middle_name": "K",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rutherfordton",
            "affiliation": "N",
            "address_1": "128 Dr Henry Norris Dr",
            "city": "Rutherfordton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281393165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rutherfordton, NC

Sources for this page

Verify at the official NPI Registry.