Individual provider Active NPI

Gwen S Johnson, MSN, RN, NPC

  • Family Nurse Practitioner
  • Batavia, OH
National Provider Identifier
1619904935
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRNCNP05049 Issued in OH
Practice address
3000 Hospital Dr Ste 130
Batavia, OH 45103-1921
Phone
(513) 735-8924
Fax
(513) 735-1740
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRNCNP05049 OH Primary

Addresses

Primary practice location

3000 Hospital Dr Ste 130
Batavia, OH 45103-1921

Mailing address

7562 Trailwind Dr
Montgomery, OH 45242-5954
Phone (513) 615-8374

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRNCNP05049OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Neurology Inc Past Accepting new patients

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1619904935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7562 TRAILWIND DR",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452425954",
            "telephone_number": "513-615-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HOSPITAL DR STE 130",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031921",
            "telephone_number": "513-735-8924",
            "fax_number": "513-735-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GWEN",
        "middle_name": "S",
        "credential": "MSN, RN, NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRNCNP05049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.