Tanja Elana Johnson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0990711 Issued in CO

Practice address

4450 Arapahoe Ave Ste 100
Boulder, CO 80303-9102

Phone

(720) 613-0677

Fax

(800) 878-1836

NPI assigned

Jun 9, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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

• Radiant Health LLC

  • Nurse Practitioner
  • Boulder, CO
  • NPI 1659853174
  NPD Authorized official

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467865394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ARAPAHOE AVE",
            "address_2": "SUITE 18",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025843",
            "telephone_number": "541-908-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 ARAPAHOE AVE STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803039102",
            "telephone_number": "720-613-0677",
            "fax_number": "800-878-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TANJA",
        "middle_name": "ELANA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN0990711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Lea Johnson, WHNP, M.S.N.
• Lyn Karol Johnson, M.A
• Mary Lynn Johnson
• Roland Lee Johnson II, BA
• Tami S. Johnson
• William M Johnson, M.D.
• Zoe Johnson
• Catherine Lee Johnston, PH.D.
• Holly E Johnston, OTR,CHT
• Juston Johnston, FNP

• Nurse Practitioner in Boulder, CO
• Providers in Boulder, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.