Carolyn S Johnson, FNP

Primary specialty

Hospice Registered NurseTaxonomy code 163WH1000X

License

R800714 Issued in MS

Practice address

1027 French Rd
Indianola, MS 38751-9605

Phone

(662) 466-0330

Fax

(662) 756-0931

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Carolyn S Johnson Professional name

Medicare fee-for-service enrollment

Enrolled in MS, KY2 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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uppal Medical Center LLC 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MDB Behavioral Health Services LLC

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310

  MS

  Medicare reassignment NPD
• Region VI Community Mental Health Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1154433233

  MS

  Medicare reassignment NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  KY, MS

  Medicare reassignment NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Care Compare group
• Garden Park

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1932437209
  NPD (past)
• Panola Physician Group, LLC

  • Family Medicine Physician
  • Batesville, MS
  • NPI 1528528874
  NPD (past)
• Saint Anthonys Hospice & Palliative Care

  • Community Based Hospice Care Agency
  • Ruleville, MS
  • NPI 1164728689
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1669975587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 FRENCH RD",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387519605",
            "telephone_number": "662-466-0330",
            "fax_number": "662-756-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 FRENCH RD",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387519605",
            "telephone_number": "662-466-0330",
            "fax_number": "662-756-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROLYN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "MS",
            "license": "R800714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "JOHNSON",
            "middle_name": "S",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Indianola, MS
• Hospice Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.