Angela Kirsten Johnston, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

65180 Issued in ID

Practice address

2243 E 17TH St
Idaho Falls, ID 83404-6519

Phone

(208) 851-2381

NPI assigned

Jun 30, 2020

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

Other names 1

• Angela Kirsten Perez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1508483173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 CHESAPEAKE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021674",
            "telephone_number": "208-851-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046519",
            "telephone_number": "208-851-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 Chesapeake Ave",
            "address_purpose": "LOCATION",
            "city": "Chubbuck",
            "state": "ID",
            "postal_code": "832021674",
            "country_code": "US",
            "telephone_number": "208-851-2381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ANGELA",
        "middle_name": "KIRSTEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "65180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PEREZ",
            "middle_name": "KIRSTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shannon Kay Johnson, LMSW
• Shelby Johnson
• Teresa Kay Johnson, MD
• Tyler L Johnson, DPT
• Alexandra Marshalle Johnston
• Marjorie Marie Johnston
• Jones Eye Care, PLLC
• Belinda Merie Jones
• Brenna Jones, LMSW
• Brian Dennis Jones, D.O., M.P.H

• Family Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.