Individual provider Active NPI

Lisa B. Johnson, ARNP

  • Adult Health Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1558393868
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30006605 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2499
Phone
(206) 744-3000
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00131825 WA
Nurse Practitioner 363L00000X AP30006605 WA
Adult Health Nurse Practitioner 363LA2200X AP30006605 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2499

Mailing address

325 9TH Ave
Box 359904
Seattle, WA 98104-2499
Phone (206) 744-5867

Other identifiers 3

IdentifierTypeStateIssuer
0201010OtherWAL&I PIN
65752UOtherWAREGENCE BLUE SHIELD PIN
9639907MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250424001202 CA Practitioner - Nurse Practitioner 8426043506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John's Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

1500 N Waterman Ave
San Bernardino, CA 92404-5111
Phone (323) 541-1600

82025 US Hwy 111
Indio, CA 92201-5686
Phone 32354116002332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00131825WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Apr 28, 2025 Accepting new patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Apr 28, 2025 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Interoperability endpoints

  • Direct secure messaging: lisa.johnson.p1@direct.crc-fwhc.nextgenshare.com

Organizations & group practices 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1558393868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "address_2": "BOX 359904",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042499",
            "telephone_number": "206-744-5867",
            "fax_number": "206-744-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042499",
            "telephone_number": "206-744-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "B.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00131825",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006605",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30006605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PIN",
            "identifier": "0201010",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD PIN",
            "identifier": "65752U",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9639907",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.