Molly Beth Johnson, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

112257 Issued in NE

Practice address

1022 Woodbury Ave
Council Bluffs, IA 51503-7915

Phone

(712) 352-0405

Fax

(712) 352-0356

NPI assigned

Jun 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Children's Physicians

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1750443503
  NPD (past)

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1457872657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 WOODBURY AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915",
            "telephone_number": "712-352-0405",
            "fax_number": "712-352-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 WOODBURY AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915",
            "telephone_number": "712-352-0405",
            "fax_number": "712-352-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MOLLY",
        "middle_name": "BETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NE",
            "license": "112257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergan Jayde Johnsen, PTA
• Teresa A Johnsen, CCC-SLP
• J Terry Johnson, DDS
• Jill Marie Johnson, LMHC, LMHP
• Lynette Johnson
• Tammy Marie Johnson, ARNP
• Wendy Marie Johnson, P.A.-C.
• Alicia Lynn Jones, DPT
• Ann R Jones, RN
• Christian Jones, M.D.

• Pediatric Nurse Practitioner in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Pediatric Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.