Individual provider Active NPI

Hailey Danielle Johnson, APRN

  • Pediatric Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1710765144
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4009482 Issued in KY
Practice address
1900 Richmond Rd
Lexington, KY 40502-1204
Phone
(859) 218-1900
Fax
(859) 218-7573
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4009482 KY Primary

Addresses

Primary practice location

1900 Richmond Rd
Lexington, KY 40502-1204

Mailing address

303 S 4TH St Ste 100
Danville, KY 40422-2091
Phone (859) 236-1080

Other practice location 1

1180 Glensboro Rd
Lawrenceburg, KY 40342-9034
Phone (502) 598-3042

Other practice location 2

303 S 4th St Ste 100
Danville, KY 40422-2091
Phone (859) 236-1080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20241206002990 KY Practitioner - Nurse Practitioner 8426584921 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4009482KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Nov 27, 2024 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

1900 Richmond Rd
Lexington, KY 40502
Phone (856) 266-2101

Organizations & group practices 1

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1710765144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S 4TH ST STE 100",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222091",
            "telephone_number": "859-236-1080",
            "fax_number": "859-236-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RICHMOND RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405021204",
            "telephone_number": "859-218-1900",
            "fax_number": "859-218-7573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1180 Glensboro Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "KY",
            "postal_code": "403429034",
            "country_code": "US",
            "telephone_number": "502-598-3042",
            "fax_number": "502-598-3184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 S 4th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "KY",
            "postal_code": "404222091",
            "country_code": "US",
            "telephone_number": "859-236-1080",
            "fax_number": "859-236-1862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HAILEY",
        "middle_name": "DANIELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "4009482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.