Active NPI
Melissa Lowder Johnson, APRN DNP PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Draper, UT
National Provider Identifier
1770210767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 3083210-4405
- Practice address
- 167 E Olive Berry LN
Draper, UT 84020-6846 - Phone
- (801) 556-0695
- NPI assigned
- Aug 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3083210-4405 | UT | Primary |
Addresses
Primary practice location
167 E Olive Berry LN
Draper, UT 84020-6846
Mailing address
167 E Olive Berry LN
Draper, UT 84020-6846
Phone (801) 556-0695
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3083210-3102 | Other | UT | UTAH DOPL |
| 3083210-4405 | Other | UT | UTAH DOPL (APRN) |
| 3083210-8900 | Other | UT | UTAH DOPL (APRN CONTROLLED SUBSTANCE) |
| 2022012145 | Other | AMERICAN NURSES CREDENTIALING CENTER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3083210-4405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1770210767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 E OLIVE BERRY LN",
"city": "DRAPER",
"state": "UT",
"postal_code": "840206846",
"telephone_number": "801-556-0695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 E OLIVE BERRY LN",
"city": "DRAPER",
"state": "UT",
"postal_code": "840206846",
"telephone_number": "801-556-0695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MELISSA",
"middle_name": "LOWDER",
"name_prefix": "Dr.",
"credential": "APRN DNP PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-01",
"last_updated": "2022-08-01",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "UT",
"license": "3083210-4405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DOPL",
"identifier": "3083210-3102",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DOPL (APRN)",
"identifier": "3083210-4405",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DOPL (APRN CONTROLLED SUBSTANCE)",
"identifier": "3083210-8900",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN NURSES CREDENTIALING CENTER",
"identifier": "2022012145",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.