Individual provider Active NPI

Oluwatosin Johnson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1912897042
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4043767 Issued in KY
Practice address
2070 Garden Springs Dr Apt 125
Lexington, KY 40504-3444
Phone
(914) 330-0937
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4043767 KY Primary

Addresses

Primary practice location

2070 Garden Springs Dr Apt 125
Lexington, KY 40504-3444

Mailing address

2070 Garden Springs Dr Apt 125
Lexington, KY 40504-3444
Phone (914) 330-0937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20260327003917 KY Practitioner - Nurse Practitioner 2769967629 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Kentucky, LLCGroup PAC ID 3173952637, 28 clinicians
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

3500 Good Samaritan Way
Louisville, KY 40299-6117
Phone (502) 267-7403

828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4043767KYMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 4

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": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1912897042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 GARDEN SPRINGS DR APT 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043444",
            "telephone_number": "914-330-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 GARDEN SPRINGS DR APT 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043444",
            "telephone_number": "914-330-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "OLUWATOSIN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4043767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.