Amanda-Grace Johnson, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

816524 Issued in NV

Practice address

1297 Boulder City Pkwy Ste a
Boulder City, NV 89005-1854

Phone

(702) 294-1919

Fax

(702) 294-0072

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

Yes

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 NV

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boulder City Hospital Hospital, Boulder City, NV, CCN 291309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda-gracejohnson@hcpnv.allscriptsdirect.net

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.

• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD
• Intermountain Medical Holdings Nevada Inc

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD
• Healthcare Partners Medical Group (Coats) LTD.

  • Pediatrics Physician
  • Las Vegas, NV
  • NPI 1902883341
  NPD (past)
• Michael R Falvo DO LTD

  • Internal Medicine Physician
  • Boulder City, NV
  • NPI 1669558284
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boulder City Hospital Inc

  • Critical Access Hospital
  • Boulder City, NV
  • NPI 1881739613
  Care Compare affiliation

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1790385136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 BOULDER CITY PKWY STE A",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051854",
            "telephone_number": "702-294-1919",
            "fax_number": "702-294-0072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Shadow Ln",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064194",
            "country_code": "US",
            "telephone_number": "702-388-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA-GRACE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "816524",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "816524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790385136",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "816524",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hallie Jim
• Joanne Grace Leovy MD LLC
• Elisa Johansson
• John M Clair DO Inc
• Allisa Johnson
• Christian Wesley Johnson, DPT
• Derek Johnson
• Rhonda Devonne Johnson
• Laura C Johnston, R.D.
• Elizabeth Anne Jones

• Family Nurse Practitioner in Boulder City, NV
• Providers in Boulder City, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.