Debra Jean Johnson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0499281 Issued in MO

Practice address

407 Main St
Golden City, MO 64748-8266

Phone

(417) 537-4311

Fax

(417) 537-4330

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Barton County Memorial Hospital

  • Family Medicine Physician
  • Lamar, MO
  • NPI 1104129733
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1497962260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "GOLDEN CITY",
            "state": "MO",
            "postal_code": "647488266",
            "telephone_number": "417-537-4311",
            "fax_number": "417-537-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "GOLDEN CITY",
            "state": "MO",
            "postal_code": "647488266",
            "telephone_number": "417-537-4311",
            "fax_number": "417-537-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBRA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MO",
            "license": "073423",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F0499281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "000050010",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RHC GROUP NUMBER",
            "identifier": "268625",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Golden City
• Cox Barton County Hospital
• Johnny Leo Divine
• Golden City R-III Schools
• Alyssa Lynn Jensen
• Vina Maureen Kahre
• Julitta J. Shirley, FNP
• Wyatt House
• Wyatt House Inc

• All providers in Golden City, MO
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.