Individual provider Active NPI

Michael Anthony Johnson, RN, ACNP

  • Nurse Practitioner
  • Abilene, TX
National Provider Identifier
1548485048
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
533709 Issued in TX
Practice address
6200 Regional PLZ
Suite 1200
Abilene, TX 79606-5250
Phone
(325) 690-1805
Fax
(325) 690-6145
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 533709 TX Primary
Acute Care Nurse Practitioner 363LA2100X 533709 TX

Addresses

Primary practice location

6200 Regional PLZ
Suite 1200
Abilene, TX 79606-5250

Mailing address

102 Waverly Cir
Abilene, TX 79602-6858
Phone (325) 690-1805

Other identifiers 1

IdentifierTypeStateIssuer
533709OtherTXRN LIC STATE OF TEXAS

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
I20090226000179 TX Practitioner - Nurse Practitioner 3072679141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
533709TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Nurse Practitioner CurrentSince May 1, 2022 Accepting new patients

Locations

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1548485048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WAVERLY CIR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796026858",
            "telephone_number": "325-690-1805",
            "fax_number": "325-690-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 REGIONAL PLZ",
            "address_2": "SUITE 1200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065250",
            "telephone_number": "325-690-1805",
            "fax_number": "325-690-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "RN, ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "533709",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "533709",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LIC STATE OF TEXAS",
            "identifier": "533709",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.