Individual provider Active NPI

Johan Nelson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • North Miami Beach, FL
National Provider Identifier
1861154478
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11015432 Issued in FL
Practice address
126 NE 169TH St
North Miami Beach, FL 33162-1752
Phone
(305) 968-0294
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11015432 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11015432 FL Primary

Addresses

Primary practice location

126 NE 169TH St
North Miami Beach, FL 33162-1752

Mailing address

126 NE 169TH St
North Miami Beach, FL 33162-1752
Phone (305) 968-0294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO, TX, VA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20260507001966 MN Practitioner - Nurse Practitioner 7416425467 Reassigns benefits to 1 organization
I20260507003436 CO Practitioner - Nurse Practitioner 7416425467 Reassigns benefits to 1 organization
I20260623001907 TX Practitioner - Nurse Practitioner 7416425467 Reassigns benefits to 1 organization
I20260623003538 VA Practitioner - Nurse Practitioner 7416425467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Miami, LM Miller School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

126 NE 169TH St
North Miami Beach, FL 33162-1752

31 Spencer St
Suite 1501
Brooklyn, NY 11205-5289

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11015432FLMDGerontology Nurse Practitioner

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1861154478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 NE 169TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331621752",
            "telephone_number": "305-968-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 NE 169TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331621752",
            "telephone_number": "305-968-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11015432",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11015432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.