Carol Johnson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20352 Issued in TN

Practice address

5545 Little Debbie Pkwy
Ooltewah, TN 37363-4357

Phone

(423) 238-5020

NPI assigned

Aug 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Crossroads Urgent Care PLLC

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Family

  NPD

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1801263132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURTON HILLS BLVD",
            "address_2": "STE 175",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156403",
            "telephone_number": "615-988-2014",
            "fax_number": "615-208-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 LITTLE DEBBIE PKWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634357",
            "telephone_number": "423-238-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Suzanne Jarrell, FNP
• Jason Vance MD a Medical Corporation
• Jason Vance MD a Medical Corporation
• Andrew Keith Johnson, DPT
• Bruce W Johnson, MD
• Jenica Johnson, RDN, LDN
• Eric Johnston, DDS
• Kayla Jones, DDS
• Audrey Josey, PA
• K-VA-T Food Stores Inc

• Family Nurse Practitioner in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.