Nathan Patrick Johnson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201701390NP-PP Issued in OR

Practice address

4035 12TH St Cutoff SE Ste 120
Salem, OR 97302

Phone

(971) 304-9306

Fax

(503) 926-6624

NPI assigned

Jul 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

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 and National Provider Directory roles.

• Stasis Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
  • NPI 1427527886

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Axis Psychiatric Services, LLC

  • Psychiatry Physician
  • Salem, OR
  • NPI 1457845182

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1952754442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12926",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973090926",
            "telephone_number": "971-304-9306",
            "fax_number": "503-926-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 12TH ST CUTOFF SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "971-304-9306",
            "fax_number": "503-926-6624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1249 Fairview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "97302",
            "country_code": "US",
            "telephone_number": "971-304-9306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1249 Fairview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "97302",
            "country_code": "US",
            "telephone_number": "971-304-9306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NATHAN",
        "middle_name": "PATRICK",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "209338",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201701389RN",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "201701390NPPP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "0000022011",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201701390NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECO, NPPES",
            "identifier": "1952754442",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda B Johnson, M.D.
• Linda P Johnson, RN
• Martin Clifton Johnson II, M.D.
• Merrilee S Johnson, RPH
• Michael Evans Johnson, L.AC.
• Reggie Johnson
• Ryan Johnson, PTA
• Ryan Christopher Johnson, MSN, NP-C
• Samuel Thomas Johnson
• Sandy Lynn Johnson, M.S.,Q.M.H.P.

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.