Individual provider Active NPI

Kristen Marie Johnson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1760901169
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020880 Issued in OH
Practice address
3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone
(614) 566-5000
Fax
(614) 566-1864
NPI assigned
Sep 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.384874 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.020880 OH Primary

Addresses

Primary practice location

3535 Olentangy River Rd
Columbus, OH 43214-3908

Mailing address

5477 Rainbow Falls Street
Dublin, OH 43016
Phone (651) 398-0286

Other identifiers 1

IdentifierTypeStateIssuer
0244216MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20171011001032 OH Practitioner - Nurse Practitioner 0840565214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.384874OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Dec 2, 2019 Accepting new patients
Ohiohealth Corporation CurrentSince Dec 2, 2019 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

Organizations & group practices 2

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": "1505606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1760901169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5477 RAINBOW FALLS STREET",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43016",
            "telephone_number": "651-398-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143908",
            "telephone_number": "614-566-5000",
            "fax_number": "614-566-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-17",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.384874",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0244216",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.