Individual provider Active NPI

Latrencia T Johnson, ARNP

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1902849870
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP630119 Issued in FL
Practice address
3885 Oakwater Cir
Orlando, FL 32806-6257
Phone
(407) 851-5600
Fax
(407) 438-0507
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP630119 FL Primary

Addresses

Primary practice location

3885 Oakwater Cir
Orlando, FL 32806-6257

Mailing address

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 851-5600

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
I20060816000269 FL Practitioner - Nurse Practitioner 2860495611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Kidney Specialists IncGroup PAC ID 6608233705, 38 clinicians

Practice addresses (Care Compare)

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 816-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP630119FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. CurrentSince Jun 1, 2010 Accepting new patients
Central Florida Kidney Specialists Inc CurrentSince Feb 6, 2025 Accepting new patients

Locations

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1902849870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "407-851-5600",
            "fax_number": "407-438-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "407-851-5600",
            "fax_number": "407-438-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LATRENCIA",
        "middle_name": "T",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP630119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.