NPIMap

Individual provider Active NPI

Tonya Caudill Johnson, FNP-BC

  • Nurse Practitioner
  • Elkin, NC
National Provider Identifier
1699412585
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5016195 Issued in NC
Practice address
401 Eldon Parks Dr
Elkin, NC 28621-2462
Phone
(336) 835-9589
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016195 NC
Nurse Practitioner 363L00000X 5016195 NC Primary

Addresses

Primary practice location

401 Eldon Parks Dr
Elkin, NC 28621-2462

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 835-9589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627000933 NC Practitioner - Nurse Practitioner 2668851304 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, 213 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1635 College Ave
Spindale, NC 28160-0016
Phone (828) 330-9190

1900 W Park Dr
Suite B
North Wilkesboro, NC 28659-3563
Phone (336) 903-6840

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jan 17, 2023 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince May 5, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince May 5, 2025 Accepting new patients
High Country Community Health CurrentSince May 11, 2022 Accepting new patients
High Country Community Health CurrentSince May 11, 2022 Accepting new patients

Locations

212 S Tryon St
Ste 100
Charlotte, NC 28281

1515 Mockingbird Ln
Ste 420
Charlotte, NC 28209
Phone (310) 230-5984

401 Eldon Parks Dr
Elkin, NC 28621
Phone (336) 835-9589

110 Dutchman Ct
Elkin, NC 28621
Phone (336) 835-5330

1900 W Park Dr
Ste B
North Wilkesboro, NC 28659
Phone (336) 903-6840

1635 College Ave
Spindale, NC 28160
Phone (828) 330-9190

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: tjohnson2753483@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1699412585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-835-9589",
            "fax_number": "336-835-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ELDON PARKS DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212462",
            "telephone_number": "336-835-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TONYA",
        "middle_name": "CAUDILL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016195",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.