Individual provider Active NPI

Judith M Johnson, MSN, APRN, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1962458182
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5379196061 Issued in KS
Practice address
8101 College Blvd Ste 100
Overland Park, KS 66210-2671
Phone
(833) 351-8255
NPI assigned
May 26, 2006
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0050-02022 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP3355 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0107511-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0050-02022 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5379196061 KS Primary

Addresses

Primary practice location

8101 College Blvd Ste 100
Overland Park, KS 66210-2671

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

3515 S 4th St
Leavenworth, KS 66048-5013
Phone (816) 845-8550

Other practice location 2

2373 Central Park Blvd Unit 100
Denver, CO 80238-2300
Phone (833) 351-8255

Other practice location 3

4435 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7651
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20201109000456 KS Practitioner - Nurse Practitioner 6406769207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alive Family PsychiatryGroup PAC ID 2961840574, 3 clinicians
Psychiatric and Counseling Associates LLCGroup PAC ID 6507881422, 41 clinicians

Practice addresses (Care Compare)

3515 S 4TH St
Suite 102
Leavenworth, KS 66048-5079
Phone (816) 845-8550

6265 Rock Chalk Dr
Lawrence, KS 66049-5232
Phone (913) 327-7505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3355AZMDPsychiatric/Mental Health Nurse Practitioner
5379196061KSMDPsychiatric/Mental Health Nurse Practitioner
0050-02022NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric and Counseling Associates LLC CurrentSince Sep 15, 2025 Accepting new patients
Alive Family Psychiatry LLC Psychiatric/Mental Health CurrentSince Nov 19, 2025 Accepting new patients
Alive Family Psychiatry LLC Psychiatric/Mental Health CurrentSince Mar 24, 2025 Accepting new patients
Alive Family Psychiatry Psychiatric/Mental Health CurrentSince Jun 20, 2025 Accepting new patients
The Richmond Center PastSince Jun 26, 2008 Accepting new patients
Community and Family Resources Past Accepting new patients
Integrated Premier Group Ipg Past Accepting new patients

Locations

3515 S 4th St
Ste 102
Leavenworth, KS 66048
Phone (816) 845-8550

380 Limit St
Leavenworth, KS 66048
Phone (816) 845-8550

8400 W 110th St
Ste 250
Overland Park, KS 66210
Phone (913) 327-7505

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.judithjohnson@154228.advancedmd-direct.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1962458182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 COLLEGE BLVD STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102671",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3515 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Leavenworth",
            "state": "KS",
            "postal_code": "660485013",
            "country_code": "US",
            "telephone_number": "816-845-8550",
            "fax_number": "816-219-6965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2373 Central Park Blvd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802382300",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4435 E Chandler Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487651",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JUDITH",
        "middle_name": "M",
        "credential": "MSN, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "0050-02022",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP3355",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0107511-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "0050-02022",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "5379196061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.