Jon David Johnson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9197452 Issued in FL

Practice address

495 E Main St
Lake Butler, FL 32054-1731

Phone

(386) 496-3211

Fax

(386) 496-1599

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Medlink Management Services Inc

  • Rural Health Clinic/Center
  • Lake Butler, FL
  • NPI 1114188927
  NPD (past)
• Solantic LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1609822592
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1730179698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12049 SW 76TH TER",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320547724",
            "telephone_number": "386-496-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 E MAIN ST",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320541731",
            "telephone_number": "386-496-3211",
            "fax_number": "386-496-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9197452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306277500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660083200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roshika Lashon Irving
• Luke Michael Jackson
• Kateena James
• Shiela Jaramillo, PHARMD
• Brandi Che' Johns
• Marvin Wade Johnson Sr., M.D.
• Chasity Kahl
• Farida Kazvinova
• Kevin B Harrison DC LLC
• Brittany Elizabeth Kilbury, CNA

• All providers in Lake Butler, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.