Individual provider Active NPI

Kelly Johnson, NP

  • Family Nurse Practitioner
  • Concord, NH
National Provider Identifier
1942651039
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
059616-23 Issued in NH
Practice address
254 Pleasant St
Concord, NH 03301-2551
Phone
(603) 582-4700
Fax
(833) 413-4978
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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 059616-23 NH Primary

Addresses

Primary practice location

254 Pleasant St
Concord, NH 03301-2551

Mailing address

46 S Main St Ste 2
Concord, NH 03301-4855
Phone (603) 582-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20160920001605 NH Practitioner - Nurse Practitioner 6103113170 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Hospital IncGroup PAC ID 6103721790, 572 clinicians
Concord Hospital-LaconiaGroup PAC ID 7012326259, 275 clinicians

Practice addresses (Care Compare)

250 Pleasant St
Concord, NH 03301-2598

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 230-3138

80 Highland St
Laconia, NH 03246-3235
Phone (603) 527-2819

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as apm
Quality
73.23
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as apm
Quality
73.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059616-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Hospital-Laconia CurrentSince Jan 18, 2023 Accepting new patients
Concord Hospital, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Riverbend Community Mental Health, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Concord Hospital, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Concord Hospital, Inc. Current Accepting new patients
Concord Hospital, Inc. Past Accepting new patients

Locations

246 Pleasant St
Concord, NH 03301
Phone (603) 224-1223

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

250 Pleasant St
Ste 6073
Concord, NH 03301
Phone 6032277000 ext. 3939

280 Pleasant St
Ste 1
Concord, NH 03301
Phone (603) 226-9800

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

238 Daniel Webster Hwy
Meredith, NH 03253
Phone (603) 279-7464

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1942651039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 S MAIN ST STE 2",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014855",
            "telephone_number": "603-582-4700",
            "fax_number": "833-413-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-582-4700",
            "fax_number": "833-413-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "059616-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.