Individual provider Active NPI

Kayla Eileen Johnson

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, WI
National Provider Identifier
1619714482
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
15562-33 Issued in WI
Practice address
700 Regent St Ste 302
Madison, WI 53715-2634
Phone
(608) 257-9700
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 15562-33 WI Primary

Addresses

Primary practice location

700 Regent St Ste 302
Madison, WI 53715-2634

Mailing address

702 Greenway Ter
Hartland, WI 53029-1168
Phone (608) 279-4995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20241010003243 WI Practitioner - Nurse Practitioner 5294267670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Stoughton Hospital 900 Ridge St
Stoughton, WI 53589
Phone (608) 279-4995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15562-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kayla Johnson LLC Psychiatric/Mental Health CurrentSince Jul 21, 2024 Accepting new patients
Group Health Cooperative of South Central Wisconsin CurrentSince Sep 9, 2024 Accepting new patients

Locations

5249 E Terrace Dr
Madison, WI 53718
Phone (608) 222-9777

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

700 Regent St
Ste 302
Madison, WI 53715
Phone (608) 406-2022

Organizations & group practices 3

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1619714482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 GREENWAY TER",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530291168",
            "telephone_number": "608-279-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 REGENT ST STE 302",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152634",
            "telephone_number": "608-257-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAYLA",
        "middle_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15562-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.