Individual provider Active NPI

Nicole Raeann Johnston, MD

  • Family Medicine Physician
  • Guttenberg, IA
National Provider Identifier
1457092280
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-55495 Issued in IA
Practice address
200 Main St
Guttenberg, IA 52052-9108
Phone
(563) 252-1121
Fax
(563) 252-5547
NPI assigned
Apr 5, 2022
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-55495 IA Primary

Addresses

Primary practice location

200 Main St
Guttenberg, IA 52052-9108

Mailing address

200 Main St
Guttenberg, IA 52052-9108
Phone (563) 252-1121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022003567 IA Practitioner - Family Practice 8022491927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guttenberg Municipal HospitalGroup PAC ID 6901709476, shared by 6 NPIs, 24 clinicians

Practice addresses (Care Compare)

200 Main St
Guttenberg, IA 52052-9108
Phone 56325211211361

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-55495IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guttenberg Municipal Hospital Current Accepting new patients
Guttenberg Municipal Hospital CurrentSince Sep 1, 2025 Accepting new patients
Guttenberg Municipal Hospital Family Medicine Current Accepting new patients
Guttenberg Municipal Hospital CurrentSince Sep 1, 2025 Accepting new patients
Guttenberg Municipal Hospital Past Accepting new patients
Guttenberg Municipal Hospital Past Accepting new patients

Locations

101 S Washington St
Edgewood, IA 52042
Phone (563) 252-1121

200 Main St
Guttenberg, IA 52052
Phone (563) 252-1121

Interoperability endpoints

  • Direct secure messaging: njohnston655414@direct.gundersenhealth.org

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

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1457092280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520529108",
            "telephone_number": "563-252-1121",
            "fax_number": "563-252-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520529108",
            "telephone_number": "563-252-1121",
            "fax_number": "563-252-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "NICOLE",
        "middle_name": "RAEANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-55495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guttenberg, IA

Sources for this page

Verify at the official NPI Registry.