Individual provider Active NPI

Jane Johansson, APRN

  • Nurse Practitioner
  • Lady Lake, FL
National Provider Identifier
1821353350
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11029749 Issued in FL
Practice address
1400 N US Highway 441 Ste 540
Lady Lake, FL 32159-8987
Phone
(352) 753-9777
Fax
(866) 446-9777
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11029749 FL
Nurse Practitioner 363L00000X APRN11029749 FL Primary

Addresses

Primary practice location

1400 N US Highway 441 Ste 540
Lady Lake, FL 32159-8987

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131210000511 CT Practitioner - Nurse Practitioner 0244467629 Reassigns benefits to 1 organization
I20150303000763 FL Practitioner - Nurse Practitioner 0244467629 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11029749FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Enterprises Inc CurrentSince Dec 27, 2023 Accepting new patients
Impact Health P.C. Nurse Practitioner CurrentSince Feb 1, 2023 Accepting new patients
Primary Options Inc PastSince Dec 27, 2023 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients

Locations

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

607 Highway 466
Lady Lake, FL 32159
Phone (352) 259-7994

Organizations & group practices 6

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1821353350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 540",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598987",
            "telephone_number": "352-753-9777",
            "fax_number": "866-446-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11029749",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11029749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.