Eileen Mary Johnson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0003418-NP Issued in CO

Practice address

4863 N Nevada Ave
Second Floor
Colorado Springs, CO 80918-3951

Phone

(719) 632-5700

Fax

(719) 260-1821

NPI assigned

Jan 2, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment NPD
• Peak Vista Community Health Centers

  dba Behavioral Health at Inside Out Youth Services

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD
• Quantum Plus LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1235188962
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1780741777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175101",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4863 N NEVADA AVE",
            "address_2": "SECOND FLOOR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183951",
            "telephone_number": "719-632-5700",
            "fax_number": "719-260-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EILEEN",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "62306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0003418-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44857314",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "CO 305289",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald L Johnson, PHARM.D
• Donna R. Johnson, PH.D.
• Douglas Scott Johnson, D.C.
• Drew Carter Johnson, DO
• Effie Leigh Johnson
• Elary Violett Johnson, PA-C
• Eliza Johnson
• Elizabeth A Johnson, PHD
• Erika Johnson, PSYD
• Erin Johnson, M.A., BCBA

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.