Individual provider Active NPI

Melissa D. Johnson, CPNP

  • Pediatric Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1821247008
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0994145 Issued in CO
Practice address
356 S McCulloch Blvd Ste 106
Pueblo, CO 81007-2848
Phone
(303) 522-1979
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 187164 CO
Pediatric Nurse Practitioner 363LP0200X 0994145 CO Primary

Addresses

Primary practice location

356 S McCulloch Blvd Ste 106
Pueblo, CO 81007-2848

Mailing address

7927 S Valleyhead Way
Aurora, CO 80016-7293
Phone (303) 522-1979

Other identifiers 1

IdentifierTypeStateIssuer
60689871MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
187164COMDCase Management Registered Nurse
0994145COMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Colorado Current Accepting new patients
Children'S Hospital Colorado-Premier Pediatrics, Inc. Past Accepting new patients
Premier Pediatrics, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: melissa.johnson.1@801.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/801/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mjohnson9862@direct.childrenscolorado.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.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1821247008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 S VALLEYHEAD WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800167293",
            "telephone_number": "303-522-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 S MCCULLOCH BLVD STE 106",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810072848",
            "telephone_number": "303-522-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CO",
            "license": "187164",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "0994145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60689871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.