Stephanie R Johnson, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60474118 Issued in WA

Practice address

8201 164TH Ave NE Ste 325
Redmond, WA 98052-7615

Phone

(425) 818-5311

Fax

(425) 434-1755

NPI assigned

Nov 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie R Mactavish Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Pathway Geriatrics PLLCGroup PAC ID 0547671125, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
• Careage Home Health Home health agency, Bellevue, WA, CCN 507102
• Providence at Home With Compassus Home Health, King Home health agency, Tukwila, WA, CCN 507068
• Kline Galland Home Health Home health agency, Seattle, WA, CCN 507121
• Evergreen Health Hospice Care Hospice, Kirkland, WA, CCN 501523
• Family Hospice Services, LLC Hospice, Bellevue, WA, CCN 501563

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

88.88

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pathway Geriatrics PLLC

  • Primary Care Clinic/Center
  • Redmond, WA
  • NPI 1154924207
  Medicare reassignment Care Compare group NPD Authorized official
• Pathway Geriatrics Residential PLLC

  • Gerontology Nurse Practitioner
  • Redmond, WA
  • NPI 1326979659
  NPD Authorized official
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Careage Home Health LLC

  • Home Health Agency
  • Bellevue, WA
  • NPI 1629288618
  Care Compare affiliation
• Caroline Kline Galland Home

  • Home Health Agency
  • Seattle, WA
  • NPI 1548513252
  Care Compare affiliation
• CP King County Wa HH, LLC

  • Home Health Agency
  • Tukwila, WA
  • NPI 1972325983
  Care Compare affiliation
• Family Hospice Services LLC.

  • Community Based Hospice Care Agency
  • Bellevue, WA
  • NPI 1932929536
  Care Compare affiliation
• King County Public Hospital District No. 2

  • Community Based Hospice Care Agency
  • Kirkland, WA
  • NPI 1285719609
  Care Compare affiliation
• King County Public Hospital District No. 2

  • Home Health Agency
  • Kirkland, WA
  • NPI 1588662761
  Care Compare affiliation

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1740557289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 164TH AVE NE STE 325",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527615",
            "telephone_number": "425-818-5311",
            "fax_number": "425-434-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 164TH AVE NE STE 325",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527615",
            "telephone_number": "425-818-5311",
            "fax_number": "425-434-1755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3615 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191042612",
            "country_code": "US",
            "telephone_number": "215-662-2746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60474118",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60474118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MACTAVISH",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Briana Wolstencroft Johnson, MOTR/L
• Holly Gulliver Johnson, BS, OTR/L
• Kara Johnson, LMP
• Mary K Johnson, LMP
• Nancy Johnson, RN
• April Jones, WALMFT
• Brian Jones, DC
• Debra L Jones
• Donald Tyler Jones
• Judith Marie Howard Jones, LMP

• Gerontology Nurse Practitioner in Redmond, WA
• Providers in Redmond, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.