NPIMap

Individual provider Active NPI

Kacie Johnson, NP-C

  • Adult Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1659806040
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP132935 Issued in TX
Practice address
800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Phone
(817) 250-4280
Fax
(817) 250-4281
NPI assigned
Apr 24, 2017
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP132935 TX Primary

Addresses

Primary practice location

800 5TH Ave Ste 500
Fort Worth, TX 76104-7304

Mailing address

800 5TH Ave Ste 500
Fort Worth, TX 76104-7304
Phone (817) 250-4280

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjohnson1170203@Direct.TexasHealth.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170613000985 TX Practitioner - Nurse Practitioner 3870861024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

800 5TH Ave
Suite 500
Fort Worth, TX 76104-7304
Phone (817) 250-4280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132935TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Jun 12, 2017 Accepting new patients
Texas Health Physicians Group CurrentSince Jun 12, 2017 Accepting new patients
Texas Health Physicians Group Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

1325 Pennsylvania Ave
Ste 890
Ft Worth, TX 76104
Phone (817) 250-4280

800 5th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 250-4280

Interoperability endpoints

  • Direct secure messaging: kjohnson1170203@direct.texashealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1659806040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047304",
            "telephone_number": "817-250-4280",
            "fax_number": "817-250-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047304",
            "telephone_number": "817-250-4280",
            "fax_number": "817-250-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KACIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP132935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjohnson1170203@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "800 5th Ave Ste 500",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761047304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.