Individual provider Active NPI

Von-Nica W. Johnson, APRN, CNM

  • Advanced Practice Midwife
  • Orange Park, FL
National Provider Identifier
1811269962
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN9233376 Issued in FL
Practice address
1680 Eagle Harbor Pkwy Ste a
Orange Park, FL 32003-4821
Phone
(904) 264-9555
Fax
(904) 215-7960
NPI assigned
Feb 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9233376 FL
Advanced Practice Midwife 367A00000X APRN9233376 FL Primary

Addresses

Primary practice location

1680 Eagle Harbor Pkwy Ste a
Orange Park, FL 32003-4821

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Other identifiers 1

IdentifierTypeStateIssuer
004548000MedicaidFL

Other names 1

  • Ms. Von-Nica R Walker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217002898 TN Practitioner - Certified Nurse Midwife (CNM) 2769641471 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Tennessee, P.C. CurrentSince Jan 21, 2021 Accepting new patients
University of Tennessee Current Accepting new patients
WT University Medical Associates Inc CurrentSince Oct 26, 2022 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

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.

NPI Registry JSON

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1811269962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 EAGLE HARBOR PKWY STE A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034821",
            "telephone_number": "904-264-9555",
            "fax_number": "904-215-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VON-NICA",
        "middle_name": "W.",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9233376",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN9233376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004548000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VON-NICA",
            "last_name": "WALKER",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "APRN, CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.