Individual provider Active NPI

Brittney Johnson

  • Pediatric Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1821616962
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383135 Issued in NY
Practice address
736 Irving Ave Ste 9100
Syracuse, NY 13210-1687
Phone
(315) 470-7379
NPI assigned
Jul 6, 2020
Last updated
Jul 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383135 NY Primary

Addresses

Primary practice location

736 Irving Ave Ste 9100
Syracuse, NY 13210-1687

Mailing address

98 Curren Dr
Elmira, NY 14905-1806
Phone (607) 329-0163

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

State licenses

LicenseStateTypeSpecialty
383135NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neonatal Associates of Central New York PC PastSince Jul 12, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1821616962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 CURREN DR",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051806",
            "telephone_number": "607-329-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE STE 9100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRITTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.