Individual provider Active NPI

Brittany Johnson

  • Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1639714785
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-137881 Issued in AL
Practice address
6163 Omni Park Dr
Mobile, AL 36609-5195
Phone
(251) 635-1315
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-137881 AL Primary

Addresses

Primary practice location

6163 Omni Park Dr
Mobile, AL 36609-5195

Mailing address

70 Midtown Park E
Mobile, AL 36606-4140
Phone (251) 289-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200214002326 AL Practitioner - Nurse Practitioner 1254767031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Alabama PCGroup PAC ID 9436211463, 42 clinicians

Practice addresses (Care Compare)

70 Midtown Park E
Mobile, AL 36606-4140
Phone (251) 289-1786

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Alabama PC CurrentSince Nov 1, 2023 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients
Alabama Psychiatric Services PC PastSince Nov 17, 2019 Accepting new patients

Locations

1851 N McKenzie St
Ste 104
Foley, AL 36535
Phone (251) 424-1880

70 Midtown Park E
Mobile, AL 36606
Phone (251) 289-1786

1940 Stonegate Dr
Ste 140
Vestavia Hls, AL 35242
Phone (205) 968-3919

1940 Stonegate Dr
Ste 130
Vestavia Hls, AL 35242
Phone (205) 451-9481

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1639714785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MIDTOWN PARK E",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064140",
            "telephone_number": "251-289-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6163 OMNI PARK DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366095195",
            "telephone_number": "251-635-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-137881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.