Individual provider Active NPI

Aditi Johnson, FNP

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1730266289
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP2538 Issued in AZ
Practice address
13555 W McDowell Rd
Suite 101
Goodyear, AZ 85395-2624
Phone
(623) 935-4700
Fax
(623) 935-4707
NPI assigned
Nov 1, 2006
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 AP2538 AZ Primary

Addresses

Primary practice location

13555 W McDowell Rd
Suite 101
Goodyear, AZ 85395-2624

Mailing address

3815 E Bell Rd Ste 2200
Phoenix, AZ 85032-2139
Phone (602) 633-3838

Other identifiers 1

IdentifierTypeStateIssuer
186422MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070522000124 AZ Practitioner - Nurse Practitioner 0547367831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

525 W Brown Rd
Mesa, AZ 85201-3202

8552 W Palo Verde Ave
Peoria, AZ 85345-5354

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC Family Medicine CurrentSince Apr 18, 2022 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Pattabi Kalyanam MD PC Past Accepting new patients
Privia Medical Group Arizona, LLC Family Medicine Past Accepting new patients
Take Care Health Arizona PC Family Past Accepting new patients

Locations

5620 W Thunderbird Rd
Ste F1
Glendale, AZ 85306
Phone (602) 938-6960

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

18433 N 19th Ave
Phoenix, AZ 85023
Phone (623) 582-9894

18435 N 19th Ave
Phoenix, AZ 85023

8030 N 19th Ave
Phoenix, AZ 85021
Phone (602) 995-1231

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1730266289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322139",
            "telephone_number": "602-633-3838",
            "fax_number": "602-633-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "SUITE 101",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952624",
            "telephone_number": "623-935-4700",
            "fax_number": "623-935-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADITI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186422",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.