Individual provider Active NPI

Amy Patrice Johnson, CRNP

  • Family Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1720979172
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-171091 Issued in AL
Practice address
6582 Boll Weevil Cir
Enterprise, AL 36330-9424
Phone
(334) 347-2027
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 1-171091 AL Primary

Addresses

Primary practice location

6582 Boll Weevil Cir
Enterprise, AL 36330-9424

Mailing address

54 County Road 164
New Brockton, AL 36351-8088
Phone (760) 792-1658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20250922001444 AL Practitioner - Nurse Practitioner 6800390840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enterprise Urgent CareGroup PAC ID 1456647197, 35 clinicians

Practice addresses (Care Compare)

6582 Boll Weevil Cir
Enterprise, AL 36330-9424
Phone (334) 347-2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Enterprise Urgent Care CurrentSince Jul 1, 2025 Accepting new patients

Locations

6582 Boll Weevil Cir
Enterprise, AL 36330
Phone (334) 347-2027

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1720979172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 COUNTY ROAD 164",
            "city": "NEW BROCKTON",
            "state": "AL",
            "postal_code": "363518088",
            "telephone_number": "760-792-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309424",
            "telephone_number": "334-347-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "PATRICE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-171091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.