Individual provider Active NPI

Diantha Lucretia Johnson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1942017561
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11036737 Issued in FL
Practice address
8140 SW 29TH St
Miramar, FL 33025-6712
Phone
(954) 854-5220
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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 11036737 FL Primary

Addresses

Primary practice location

8140 SW 29TH St
Miramar, FL 33025-6712

Mailing address

8140 SW 29TH St
Miramar, FL 33025-6712
Phone (954) 854-5220

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
I20260108000076 FL Practitioner - Nurse Practitioner 3870655970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD at Home Central Florida, LLCGroup PAC ID 5395109433, 27 clinicians

Practice addresses (Care Compare)

8201 Peters Rd
Suite 1000
Plantation, FL 33324-3266
Phone (312) 243-2223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11036737FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MD at Home Central Florida, LLC CurrentSince Dec 29, 2025 Accepting new patients

Locations

8201 Peters Rd
Ste 1000
Plantation, FL 33324
Phone (312) 243-2223

Organizations & group practices 1

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1942017561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 SW 29TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256712",
            "telephone_number": "954-854-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 SW 29TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256712",
            "telephone_number": "954-854-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DIANTHA",
        "middle_name": "LUCRETIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11036737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.