Individual provider Active NPI

Lauren Rae Johnson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sikeston, MO
National Provider Identifier
1740981422
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023008813 Issued in MO
Practice address
1012 N Main St
Sikeston, MO 63801-5044
Phone
(573) 471-0330
NPI assigned
Mar 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023008813 MO Primary

Addresses

Primary practice location

1012 N Main St
Sikeston, MO 63801-5044

Mailing address

1012 N Main St
Sikeston, MO 63801-5097
Phone (573) 471-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230407000925 MO Practitioner - Nurse Practitioner 2466827316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

1008 N Main St
Missouri Delta Medical Center
Sikeston, MO 63801-5044
Phone (573) 471-1600

1012 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-0330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023008813MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Apr 24, 2023 Accepting new patients
Saint Francis Medical Center CurrentSince Apr 24, 2023 Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721

1012 N Main St
Sikeston, MO 63801
Phone (573) 471-0330

1012 N Main St
#Saint
Sikeston, MO 63801
Phone (573) 471-0330

Interoperability endpoints

  • Direct secure messaging: lryan25011@surescripts.sfmc.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1740981422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015097",
            "telephone_number": "573-471-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAUREN",
        "middle_name": "RAE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023008813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.