Individual provider Active NPI

Elizabeth Johnson, FNP

  • Family Nurse Practitioner
  • Austintown, OH
National Provider Identifier
1801221114
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP.022154 Issued in OH
Practice address
5760 Patriot Blvd Ste C
Austintown, OH 44515-1170
Phone
(330) 270-8610
Fax
(330) 270-2690
NPI assigned
Sep 5, 2013
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP.022154 OH Primary
Registered Nurse 163W00000X RN 312490 OH

Addresses

Primary practice location

5760 Patriot Blvd Ste C
Austintown, OH 44515-1170

Mailing address

65 Messimer Dr
Newark, OH 43055-1874
Phone (740) 522-8477

Other practice location 1

41299 Metz Rd
Columbiana, OH 44408-9492
Phone (740) 602-0855

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
I20140613001744 OH Practitioner - Nurse Practitioner 5890919823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cope Treatment Centers inGroup PAC ID 1951404540, 12 clinicians

Practice addresses (Care Compare)

15613 Pineview Dr
Suite 3C
East Liverpool, OH 43920-9096
Phone (330) 542-9920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 312490OHMDRegistered Nurse
CNP.022154OHMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1801221114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MESSIMER DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551874",
            "telephone_number": "740-522-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD STE C",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-270-8610",
            "fax_number": "330-270-2690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41299 Metz Rd",
            "address_purpose": "LOCATION",
            "city": "Columbiana",
            "state": "OH",
            "postal_code": "444089492",
            "country_code": "US",
            "telephone_number": "740-602-0855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP.022154",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 312490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.