Jody Johnson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11005397 Issued in FL

Practice address

1341 Bedford Dr
Melbourne, FL 32940-1986

Phone

(321) 622-8031

NPI assigned

Feb 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, KS2 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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellsworth County Medical Center 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellsworth County Medical Center Hospital, Ellsworth, KS, CCN 171327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (9 of 10)

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23115/brand/1/csg/1/fhir/r4

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.

• Ellsworth County Medical Center

  • Critical Access Hospital
  • Ellsworth, KS
  • NPI 1083614028

  KS

  Medicare reassignment Care Compare group NPD
• Ellsworth County Medical Center

  • Rural Health Clinic/Center
  • Ellsworth, KS
  • NPI 1972504546

  KS

  Medicare reassignment Care Compare group NPD
• Glomar Medical Inc.

  • Gerontology Nurse Practitioner
  • Palm Bay, FL
  • NPI 1053913095

  FL

  Medicare reassignment NPD
• Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1285735605

  FL

  Medicare reassignment NPD
• Ellsworth County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Ellsworth, KS
  • NPI 1063479145
  Care Compare group
• Ellsworth County Medical Center

  • Rural Health Clinic/Center
  • Wilson, KS
  • NPI 1215937263
  Care Compare group
• Ellsworth County Medical Center

  • Rural Health Clinic/Center
  • Lucas, KS
  • NPI 1215937289
  Care Compare group
• Ellsworth County Medical Center

  • Rural Health Clinic/Center
  • Holyrood, KS
  • NPI 1689674657
  Care Compare group
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Sebastian, FL
  • NPI 1376421479
  NPD
• Post Acute Care Leaders-Florida LLC

  • Nurse Practitioner
  • Vero Beach, FL
  • NPI 1578119194
  NPD
• Centennial Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Melbourne, FL
  • NPI 1730682642
  NPD (past)
• Via Healthcare LLC

  • Primary Care Clinic/Center
  • Melbourne, FL
  • NPI 1467014431
  NPD (past)

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

• Ellsworth County Medical Center

  • Critical Access Hospital
  • Ellsworth, KS
  • NPI 1083614028

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1962035667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 BEDFORD DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 BEDFORD DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401986",
            "telephone_number": "321-622-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JODY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Johnson
• Cassie Renea Johnson, RDN, CPT
• David Nichols Johnson, CRNA
• Gracie Johnson
• Jalaya Johnson
• Julie Johnson, APRN, RN, BSN
• Kathleen C Johnson, APRN, CNM
• Kenneth Edward Johnson, PHARMD
• Khatriena D Johnson, APRN
• Lena E Johnson, MD

• All providers in Melbourne, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.