Individual provider Active NPI

Anita Leigh Johnson, NP

  • Family Nurse Practitioner
  • Merced, CA
National Provider Identifier
1477106383
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F12180594 Issued in CA
Practice address
3349 G Street
Suite C BLDG. K , El Portal Plaza
Merced, CA 95340
Phone
(209) 580-4638
Fax
(809) 580-4163
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 F12180594 CA Primary

Addresses

Primary practice location

3349 G Street
Suite C BLDG. K , El Portal Plaza
Merced, CA 95340

Mailing address

3349 G St Ste C
Merced, CA 95340-0978
Phone (209) 580-4638

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL meditab Provident Primary Care Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200817003946 CA Practitioner - Nurse Practitioner 0648696922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

315 Mercy Ave
Suite 400
Merced, CA 95340-8368
Phone (209) 564-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F12180594CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Dec 11, 2023 Accepting new patients
Dignity Health Medical Foundation CurrentSince Dec 11, 2023 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients

Locations

315 Mercy Ave
Ste 400
Merced, CA 95340
Phone (209) 564-3700

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1477106383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G ST STE C",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-580-4638",
            "fax_number": "209-580-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G STREET",
            "address_2": "SUITE C BLDG. K , EL PORTAL PLAZA",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95340",
            "telephone_number": "209-580-4638",
            "fax_number": "809-580-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANITA",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F12180594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "meditab",
            "affiliation": "Y",
            "affiliationName": "Provident Primary Care Inc",
            "address_1": "3349 G St Ste C",
            "city": "Merced",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953400978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.