Laura L. Johnson, N.P., P.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201050002NP Issued in OR

Legal business name

LAURA L. JOHNSON, N.P., P.C.

Doing business as

Crater Lake Medical South

Practice address

21990 Highway 62
Shady Cove, OR 97539-9717

Phone

(541) 878-2022

Fax

(541) 878-1498

NPI assigned

Feb 28, 2018

Last updated

Jun 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Lynn Johnson, NP-CNPI 1023348430

Title

Nurse Practitioner

Phone

(541) 890-8826

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crater Lake Medical South Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Interoperability endpoints

• Direct secure messaging: angelahagerty@ljohnnppc.allscriptsdirect.net
• Direct secure messaging: laurajohnson@ljohnnppc.allscriptsdirect.net
• Direct secure messaging: taraholley@ljohnnppc.allscriptsdirect.net

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura Lynn Johnson, FNP

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1023348430
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1447752035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975390508",
            "telephone_number": "541-878-2022",
            "fax_number": "541-878-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21990 HIGHWAY 62",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975399717",
            "telephone_number": "541-878-2022",
            "fax_number": "541-878-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA L. JOHNSON, N.P., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "541-890-8826",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201050002NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500616623",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crater Lake Medical South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ryan Stuart Price, MA, LPC

• Family Nurse Practitioner in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.