Individual provider Active NPI

Rene Johnson, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1902120082
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
R134332 Issued in MD
Practice address
173 Saint Patricks Dr Ste 104
Waldorf, MD 20603-5530
Phone
(888) 731-8994
NPI assigned
Mar 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R134332 MD
Obstetrics & Gynecology Nurse Practitioner 363LX0001X R134332 MD Primary

Addresses

Primary practice location

173 Saint Patricks Dr Ste 104
Waldorf, MD 20603-5530

Mailing address

173 Saint Patricks Dr Ste 104
Waldorf, MD 20603-5530
Phone (888) 731-8994

Other practice location 1

601 Pennsylvania Ave NW Bldg Suite900
Washington, DC 20004-2601
Phone (888) 731-8994

Other practice location 2

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

Other practice location 3

1101 Wilson Blvd Fl 6
Arlington, VA 22209-2281
Phone (888) 731-8994

Other identifiers 1

IdentifierTypeStateIssuer
058443600MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rene.johnson.p1@direct.cwcare.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20121022000059 DC Practitioner - Nurse Practitioner 8729238142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
43.1 of 100Reported as group
Quality
7.9
Improvement activities
40
Cost
79.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. CurrentSince Sep 5, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

11850 W Market Pl
Ste P
Fulton, MD 20759

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

9711 Medical Center Dr
Ste 109
Rockville, MD 20850
Phone (301) 762-5501

Interoperability endpoints

  • Direct secure messaging: rene.johnson.1@27069.direct.athenahealth.com
  • Direct secure messaging: rene.johnson.p1@direct.cwcare.nextgenshare.com

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1902120082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035530",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035530",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Pennsylvania Ave NW Bldg Suite900",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200042601",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Wilson Blvd Fl 6",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222092281",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RENE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R134332",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MD",
            "license": "R134332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058443600",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rene.johnson.p1@direct.cwcare.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9420 Key West Ave",
            "address_2": "Suite 415",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208503334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.