Individual provider Active NPI

Daniele Nichole Johnson, FNP-C

  • Family Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1487425369
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R196177 Issued in MD
Practice address
116 Defense Hwy Ste 400
Annapolis, MD 21401-7050
Phone
(410) 897-9841
NPI assigned
Jan 10, 2024
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 R196177 MD Primary

Addresses

Primary practice location

116 Defense Hwy Ste 400
Annapolis, MD 21401-7050

Mailing address

207 Truck Farm Dr
Glen Burnie, MD 21061-5154
Phone (144) 361-8064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240226004214 MD Practitioner - Nurse Practitioner 5890138622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Annapolis Internal Medicine, LLCGroup PAC ID 2163324997, 22 clinicians

Practice addresses (Care Compare)

116 Defense Hwy
Suite 400
Annapolis, MD 21401-7050
Phone (410) 897-9841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R196177MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Internal Medicine, LLC CurrentSince Mar 1, 2024 Accepting new patients
Titus C. Abraham, MD, LLC Past Accepting new patients

Locations

116 Defense Hwy
Ste 400
Annapolis, MD 21401
Phone (410) 897-9841

Interoperability endpoints

  • Direct secure messaging: daniele.johnson.1@3805.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3805/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 8

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": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1487425369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 TRUCK FARM DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615154",
            "telephone_number": "144-361-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 400",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017050",
            "telephone_number": "410-897-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIELE",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R196177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.