Individual provider Active NPI

Patricia Ann Johnson, F.N.P., C.N.M.

  • Family Nurse Practitioner
  • Nags Head, NC
National Provider Identifier
1457402828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NC 21509 Issued in NC
Practice address
2518 S Croatan Hwy
Nags Head, NC 27959-8808
Phone
(252) 441-2144
Fax
(252) 441-5853
NPI assigned
Jan 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NC 21509 NC Primary

Addresses

Primary practice location

2518 S Croatan Hwy
Nags Head, NC 27959-8808

Mailing address

1605 Wood Duck LN
Kill Devil Hills, NC 27948-6917
Phone (252) 441-2144

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
NC 21509NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457402828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WOOD DUCK LN",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279486917",
            "telephone_number": "252-441-2144",
            "fax_number": "252-441-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598808",
            "telephone_number": "252-441-2144",
            "fax_number": "252-441-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "F.N.P., C.N.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "NC 21509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.