Individual provider Active NPI

Anneka Clarise Johnson, APRN

  • Adult Health Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1912283078
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9251342 Issued in FL
Practice address
1720 S Gadsden St
Tallahassee, FL 32301-5506
Phone
(850) 576-4073
NPI assigned
Nov 2, 2011
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9251342 FL Primary

Addresses

Primary practice location

1720 S Gadsden St
Tallahassee, FL 32301-5506

Mailing address

1115 W Call St
Tallahassee, FL 32306-4300
Phone (850) 644-1543

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
I20170919002528 FL Practitioner - Nurse Practitioner 6800104647 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9251342FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bond Community Health Center, Inc. Adult Health CurrentSince Jul 23, 2020 Accepting new patients
Bond Community Health Center, Inc. CurrentSince Jul 23, 2020 Accepting new patients

Locations

1720 S Gadsden St
Tallahassee, FL 32301
Phone (850) 576-4073

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": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1912283078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W CALL ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323064300",
            "telephone_number": "850-644-1543",
            "fax_number": "850-645-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S GADSDEN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015506",
            "telephone_number": "850-576-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNEKA",
        "middle_name": "CLARISE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9251342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.