Individual provider Active NPI

Michelle Laurane Johnson, NP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1801519087
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1070688 Issued in TX
Practice address
5701 Bryant Irvin Rd Ste 301
Fort Worth, TX 76132-4027
Phone
(817) 912-9800
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1070688 TX Primary

Addresses

Primary practice location

5701 Bryant Irvin Rd Ste 301
Fort Worth, TX 76132-4027

Mailing address

5701 Bryant Irvin Rd Ste 301
Fort Worth, TX 76132-4027
Phone (214) 557-0530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230112002774 TX Practitioner - Nurse Practitioner 5799156584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

5701 Bryant Irvin Rd
Fort Worth, TX 76132-4027

6420 Altamesa Blvd
Suite 100
Fort Worth, TX 76132-3553
Phone (817) 912-9000

Hospital & facility affiliations

  • Baylor Institute for Rehabilitation at Fort Worth Inpatient rehabilitation facility, Fort Worth, TX, CCN 673035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1070688TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 9, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 9, 2023 Accepting new patients
Healthtexas Provider Network Current Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

5701 Bryant Irvin Rd
Ste 301
Ft Worth, TX 76132
Phone (817) 346-4242

Interoperability endpoints

  • Direct secure messaging: mjohnson485389@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1801519087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324027",
            "telephone_number": "214-557-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324027",
            "telephone_number": "817-912-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "LAURANE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1070688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.