Individual provider Active NPI

Joycelyn Ra'Tosha Johnson, CRNP

  • Family Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1740949940
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131443 Issued in AL
Practice address
1615 Kathy LN SW Ste 102
Decatur, AL 35603-1026
Phone
(256) 686-4441
NPI assigned
Dec 15, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 1-131443 AL Primary

Addresses

Primary practice location

1615 Kathy LN SW Ste 102
Decatur, AL 35603-1026

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

Other practice location 1

2205 Beltline Rd SW
Decatur, AL 35601-3617
Phone (256) 973-4000

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
I20220105000863 AL Practitioner - Nurse Practitioner 8022409879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Russellville Hospital Inc.Group PAC ID 3476878489, 66 clinicians
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

15225 Hwy 43
Suite I
Russellville, AL 35653-1969
Phone (256) 331-2700

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1-131443ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Russellville Hospital Inc CurrentSince Jan 1, 2022 Accepting new patients
Integrated Behavioral Health, Inc. Family CurrentSince Jan 1, 2022 Accepting new patients
Russellville Hospital Inc Current Accepting new patients
Russellville Hospital Inc Past Accepting new patients

Locations

1615 Kathy Ln SW
Ste 102
Decatur, AL 35603
Phone (256) 686-4441

2205 Beltline Rd SW
Decatur, AL 35601
Phone (256) 306-4000

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

1040 Longfield Ct
Montgomery, AL 36117
Phone (334) 288-9009

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/15210b52-659d-4e08-a38d-3a74b25af386

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1740949940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 KATHY LN SW STE 102",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031026",
            "telephone_number": "256-686-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Beltline Rd SW",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356013617",
            "country_code": "US",
            "telephone_number": "256-973-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOYCELYN",
        "middle_name": "RA'TOSHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.