Individual provider Active NPI

Anthony Lee Johnston, RN

  • Wound Care Registered Nurse
  • Omaha, NE
National Provider Identifier
1912784109
Registry record updated Oct 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
License
101635 Issued in NE
Practice address
4350 Dewey Ave
Omaha, NE 68105-1017
Phone
(402) 552-2490
Fax
(402) 552-2471
NPI assigned
Sep 11, 2023
Last updated
Oct 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 101635 NE
Wound Care Registered Nurse 163WW0000X 101635 NE Primary

Addresses

Primary practice location

4350 Dewey Ave
Omaha, NE 68105-1017

Mailing address

987400 Nebraska Medical Ctr
Attn: Hbo
Omaha, NE 68198-7400
Phone (402) 552-2490

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0198077COMDWound Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792886400000",
    "number": "1912784109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987400 NEBRASKA MEDICAL CTR",
            "address_2": "ATTN: HBO",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681987400",
            "telephone_number": "402-552-2490",
            "fax_number": "402-552-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 DEWEY AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051017",
            "telephone_number": "402-552-2490",
            "fax_number": "402-552-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ANTHONY",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2026-10-25",
        "certification_date": "2026-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": "101635",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NE",
            "license": "101635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2026; 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.