Vickie M Johnson, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

13530 Issued in TN

Practice address

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818

Phone

(847) 275-9504

NPI assigned

Jan 12, 2010

Last updated

Jul 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AR, NC3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Supportive Psych Care of Arkansas PAGroup PAC ID 8820474661, 42 clinicians

Capeside Psychiatry PLLCGroup PAC ID 5991926560, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Capeside Psychiatry, PLLC

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1760891980
  Medicare reassignment Care Compare group NPD
• Supportive Psych Care of Arkansas PA

  • Psychiatry Physician
  • Siloam Springs, AR
  • NPI 1437887437
  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Mid-Atlantic H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1275427429

  TN

  Medicare reassignment NPD
• Home Assistance LLC

  • Community/Behavioral Health Agency
  • Bartlett, TN
  • NPI 1225525181

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Phillip R. Bowden, M.D.,P.a.

  • Gastroenterology Physician
  • Memphis, TN
  • NPI 1932216389
  Medicare reassignment NPD
• Saint Francis Physician Network, LLC

  • Family Medicine Physician
  • Covington, TN
  • NPI 1295258002
  Medicare reassignment NPD
• Step Up Care of Tennessee LLC

  • Psychologist
  • Memphis, TN
  • NPI 1023660206
  Medicare reassignment NPD
• Vitality Ageless Center LLC

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1326843277
  Medicare reassignment NPD
• Mind Rebirth PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1144956392
  NPD Authorized official
• Mind Rebirth PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1457089880
  NPD Authorized official
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  TN

  Medicare reassignment
• Healthcare Network Tennessee, Inc.

  • Neurological Surgery Physician
  • Memphis, TN
  • NPI 1932708054
  NPD

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1922338086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22403",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154476",
            "telephone_number": "888-402-7256",
            "fax_number": "888-902-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "847-275-9504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Judges Rd Ste 4E",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284053655",
            "country_code": "US",
            "telephone_number": "910-791-6767",
            "fax_number": "910-399-2190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Elizabeth St Ste D",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285405681",
            "country_code": "US",
            "telephone_number": "910-791-6767",
            "fax_number": "910-399-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICKIE",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "13530",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "13530",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5022905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya La-Shawn Johnson, BSCJA, MSP
• Terrence Johnson, M.A.
• Tiffany Johnson
• Tomika Johnson
• Tyyanna Johnson
• Victoria Johnson
• Waynisha Johnson
• Zawana Johnson
• Gordon Johnston
• Jennifer Johnston

• Nurse Practitioner in Novi, MI
• Providers in Novi, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.