Individual provider Active NPI

Amber R Johnson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Meriden, CT
National Provider Identifier
1679158075
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9542 Issued in CT
Practice address
883 Paddock Ave
Meriden, CT 06450-7044
Phone
(203) 630-5356
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9542 CT Primary

Addresses

Primary practice location

883 Paddock Ave
Meriden, CT 06450-7044

Mailing address

883 Paddock Ave
Meriden, CT 06450-7044
Phone (203) 630-5356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210712003900 CT Practitioner - Nurse Practitioner 8224430301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rushford Center IncGroup PAC ID 1153227756, 26 clinicians

Practice addresses (Care Compare)

883 Paddock Ave
Meriden, CT 06450-7044
Phone (203) 630-5220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Aug 28, 2021 Accepting new patients
Rushford Center, Inc. CurrentSince Aug 28, 2021 Accepting new patients
Hartford Hospital CurrentSince Aug 28, 2021 Accepting new patients

Locations

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

883 Paddock Ave
Meriden, CT 06450
Phone (203) 630-5220

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: acolello78169@xdr.hhchealthdirect.org

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": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1679158075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMBER",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "9542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.