Alice Joan Johnson, MSN, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

67196 Issued in ID

Practice address

990 Limestone Dr
Idaho Falls, ID 83404-8313

Phone

(801) 410-2293

NPI assigned

Jun 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, 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.

• Ashton Memorial, Inc.

  dba Youth and Family Renewal Services

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1003907163
  Medicare reassignment NPD
• Ashton Memorial, Inc.

  dba Ashton Living Center

  • Skilled Nursing Facility
  • Ashton, ID
  • NPI 1497756803
  NPD
• Ashton Memorial, Inc.

  dba Ashton Medical Clinic

  • Health Service Clinic/Center
  • Ashton, ID
  • NPI 1588991566
  NPD

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1528799103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 LIMESTONE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048313",
            "telephone_number": "801-410-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 LIMESTONE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048313",
            "telephone_number": "801-410-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALICE",
        "middle_name": "JOAN",
        "credential": "MSN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "67196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Thomas John, PSY
• Timmie Lyn John, LMSW
• Paul W. Johns, MD
• Rodney Cordell Johns, DMD
• Sarah Rose Johnsen
• Alicia Johnson
• Anita Ann Johnson, M.T.
• Ashley Renee Johnson, LMSW
• Benjamin Jacob Johnson, PA-C
• Brianne Michelle Johnson, CF-SLP

• 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 Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.