Individual provider Active NPI

Johannah Marie Cacio, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Littleton, NH
National Provider Identifier
1659914836
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
077905-23 Issued in NH
Practice address
29 Maple St
Littleton, NH 03561-4729
Phone
(603) 444-5358
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 077905-21 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 077905-23 NH Primary

Addresses

Primary practice location

29 Maple St
Littleton, NH 03561-4729

Mailing address

29 Maple St
Littleton, NH 03561-4729
Phone (603) 444-5358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231004002511 NH Practitioner - Nurse Practitioner 3375998776 Reassigns benefits to 1 organization
I20240515003439 VT Practitioner - Nurse Practitioner 3375998776

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

461 Main St
Franconia, NH 03580-4835
Phone (603) 377-8687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077905-21NHMDCommunity Health Registered Nurse
077905-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Ahead LLC Psychiatric/Mental Health CurrentSince Apr 13, 2024 Accepting new patients
Blue Spruce Health PLLC CurrentSince Mar 30, 2024 Accepting new patients
Northern Human Services PastSince Oct 27, 2019 Accepting new patients

Locations

461 Main St
Franconia, NH 03580
Phone (603) 377-8687

401 E Main St
Newport, VT 05855
Phone (802) 327-7079

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1659914836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MAPLE ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035614729",
            "telephone_number": "603-444-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MAPLE ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035614729",
            "telephone_number": "603-444-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACIO",
        "first_name": "JOHANNAH",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NH",
            "license": "077905-21",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "077905-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, NH

Sources for this page

Verify at the official NPI Registry.