Individual provider Active NPI

Lynn J Johnston, FNP, PNP-C

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1609021344
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
246295 Issued in CA
Practice address
5011 Rick Dr
Santa Rosa, CA 95409-2734
Phone
(707) 538-4937
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 246295 CA Primary
Pediatric Nurse Practitioner 363LP0200X 246295 CA

Addresses

Primary practice location

5011 Rick Dr
Santa Rosa, CA 95409-2734

Mailing address

3420 Chanate Rd
Santa Rosa, CA 95404-1710
Phone (707) 565-4820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
246295CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1609021344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041710",
            "telephone_number": "707-565-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 RICK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092734",
            "telephone_number": "707-538-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "LYNN",
        "middle_name": "J",
        "credential": "FNP, PNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "246295",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "246295",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.