Individual provider Active NPI

Alysia Johnson, NNP

  • Neonatal Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1619331436
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
791930 Issued in TX
Practice address
520 E 6TH St
Odessa, TX 79761-4527
Phone
(432) 582-8000
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 791930 TX Primary

Addresses

Primary practice location

520 E 6TH St
Odessa, TX 79761-4527

Mailing address

PO Box 1627
Stanton, TX 79782-1627
Phone (432) 661-3935

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
791930TXMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1619331436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1627",
            "city": "STANTON",
            "state": "TX",
            "postal_code": "797821627",
            "telephone_number": "432-661-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614527",
            "telephone_number": "432-582-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALYSIA",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "791930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.