Individual provider Active NPI

Brittnai Johnson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1821562570
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11001229 Issued in FL
Practice address
3333 W 20TH St
Jacksonville, FL 32254-1703
Phone
(904) 695-9145
Fax
(904) 695-2465
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11001229 FL Primary

Addresses

Primary practice location

3333 W 20TH St
Jacksonville, FL 32254-1703

Mailing address

PO Box 19249
Jacksonville, FL 32245-9249
Phone (904) 743-1883

Other identifiers 1

IdentifierTypeStateIssuer
APRN11001229OtherFLPROFESSIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190306001821 FL Practitioner - Nurse Practitioner 6901145119 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11001229FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc CurrentSince Feb 4, 2019 Accepting new patients

Locations

3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364

4427 Emerson St
Ste 5
Jacksonville, FL 32207
Phone (904) 745-0042

11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100

Organizations & group practices 1

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1821562570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19249",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459249",
            "telephone_number": "904-743-1883",
            "fax_number": "904-695-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W 20TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541703",
            "telephone_number": "904-695-9145",
            "fax_number": "904-695-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRITTNAI",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11001229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "APRN11001229",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.