Individual provider Active NPI

Roberta Johnson, APRN

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1518848977
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1056653 Issued in TX
Practice address
4525 Heritage Trace Pkwy Ste 117
Fort Worth, TX 76244-8910
Phone
(817) 267-6290
Fax
(817) 267-0950
NPI assigned
Sep 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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 1056653 TX Primary

Addresses

Primary practice location

4525 Heritage Trace Pkwy Ste 117
Fort Worth, TX 76244-8910

Mailing address

3030 Harwood Rd Ste 100
Bedford, TX 76021-3703
Phone (817) 267-6290

Other practice location 1

3030 Harwood Rd Ste 100
Bedford, TX 76021-3703
Phone (817) 267-6290

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address roberta.johnson.1@29952.direct.athenahealth.com Direct
Direct Messaging Address roberta.johnson.1@29952.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20251021000853 TX Practitioner - Nurse Practitioner 3375031578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Cities Neurology Associates, P.a.Group PAC ID 0749379592, 12 clinicians

Practice addresses (Care Compare)

3030 Harwood Rd
Suite 100
Bedford, TX 76021-3703
Phone (817) 267-6290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1056653TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Cities Neurology Associates, P.a. Neurology CurrentSince Oct 6, 2025 Accepting new patients

Locations

1305 Airport Fwy
Ste 205
Bedford, TX 76021
Phone (817) 267-6290

3030 Harwood Rd
Ste 100
Bedford, TX 76021
Phone (817) 267-6290

4525 Heritage Trace Pkwy
Ste 117
Fort Worth, TX 76244
Phone (817) 267-6290

Interoperability endpoints

  • Direct secure messaging: roberta.johnson.1@29952.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1518848977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HARWOOD RD STE 100",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213703",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 HERITAGE TRACE PKWY STE 117",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448910",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Harwood Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "TX",
            "postal_code": "760213703",
            "country_code": "US",
            "telephone_number": "817-267-6290",
            "fax_number": "817-267-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERTA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roberta.johnson.1@29952.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address - used for all locations",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4525 Heritage Trace Pkwy Ste 117",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762448910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roberta.johnson.1@29952.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address - used for all locations",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3030 Harwood Rd Ste 100",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760213703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.