Individual provider Active NPI

Lori Johnson, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1679939987
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71006065 Issued in IN
Practice address
10561 Jacks Way
Indianapolis, IN 46234-4065
Phone
(317) 995-3264
NPI assigned
Jan 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71006065 IN Primary
Family Nurse Practitioner 363LF0000X 71006065A IN

Addresses

Primary practice location

10561 Jacks Way
Indianapolis, IN 46234-4065

Mailing address

10561 Jacks Way
Indianapolis, IN 46234-4065
Phone (317) 995-3264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160505002037 IN Practitioner - Nurse Practitioner 0648579086 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC CurrentSince Apr 1, 2022 Accepting new patients
Onhealthcare LLC CurrentSince Apr 1, 2022 Accepting new patients
S4 Specialty Consultants LLC CurrentSince Feb 1, 2023 Accepting new patients
Holon Health Great Lakes, P.C. CurrentSince Feb 17, 2024 Accepting new patients
Onhealthcare, LLC Current Accepting new patients
Holon Health, Inc. PastSince Mar 3, 2024 Accepting new patients
Laurus Practitioners PastSince Aug 29, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

8425 Woodfield Crossing Blvd
Ste 100
Indianapolis, IN 46240
Phone (317) 537-9522

675 Justice Way
Indianapolis, IN 46203
Phone (317) 327-1700

675 Justice Way
Rm C49
Indianapolis, IN 46203
Phone (219) 798-3361

3540 Pump Rd
Richmond, VA 23233
Phone (804) 404-6270

Organizations & group practices 8

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": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1679939987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10561 JACKS WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462344065",
            "telephone_number": "317-995-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10561 JACKS WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462344065",
            "telephone_number": "317-995-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LORI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71006065",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006065A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.