Individual provider Active NPI

Channing Johnson, ARNP, FNP-C

  • Family Nurse Practitioner
  • Clive, IA
National Provider Identifier
1679308373
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A181114 Issued in IA
Practice address
1601 NW 114TH St Ste 255
Clive, IA 50325-7036
Phone
(515) 461-9780
Fax
(515) 461-9779
NPI assigned
Sep 4, 2024
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A181114 IA Primary

Addresses

Primary practice location

1601 NW 114TH St Ste 255
Clive, IA 50325-7036

Mailing address

PO Box 674721
Dallas, TX 75267-4721
Phone (515) 643-2519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20241014002822 IA Practitioner - Nurse Practitioner 4880126945 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Des Moines River Physicians LLCGroup PAC ID 0143549634, 45 clinicians
Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-3121

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Aug 1, 2025 Accepting new patients
Mercy Clinics, Inc CurrentSince Aug 1, 2026 Accepting new patients
Des Moines River Physicians, LLC CurrentSince Sep 5, 2024 Accepting new patients
Broadlawns Medical Center CurrentSince Aug 1, 2025 Accepting new patients
Des Moines River Physicians, LLC CurrentSince Sep 5, 2024 Accepting new patients
Mercy Clinics, Inc. PastSince Aug 1, 2026 Accepting new patients

Locations

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

350 E Hickman Rd
Waukee, IA 50263
Phone (515) 643-7090

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

Interoperability endpoints

  • Direct secure messaging: cjohnson3948415@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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 4

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1679308373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674721",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674721",
            "telephone_number": "515-643-2519",
            "fax_number": "515-461-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST STE 255",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257036",
            "telephone_number": "515-461-9780",
            "fax_number": "515-461-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHANNING",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A181114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.