Gary Taylour Johnson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0028127 Issued in OH

Practice address

1440 Jefferson Street
Greenfield, OH 45123

Phone

(937) 981-2880

NPI assigned

Apr 17, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Pure Health Management Inc.

  • Chiropractor
  • Chillicothe, OH
  • NPI 1922501691

  Family, OH

  Medicare reassignment NPD
• Roman Family Healthcare

  • Family Medicine Physician
  • Greenfield, OH
  • NPI 1821654674

  OH

  Medicare reassignment

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1972990836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W SPRINGFIELD ST",
            "city": "FRANKFORT",
            "state": "OH",
            "postal_code": "456288008",
            "telephone_number": "740-649-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 JEFFERSON STREET",
            "city": "GREENFIELD",
            "state": "OH",
            "postal_code": "45123",
            "telephone_number": "937-981-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054720",
            "country_code": "US",
            "telephone_number": "937-723-4065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "TAYLOUR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "390421",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonah Humphries, DC
• Desiree Nicole Jackson
• Jacob J. Bissonette DDS, LLC
• Kirthi Kavya Jetty, DO
• Betty C Johnson
• Leah Johnson
• Brandy M Jordan, MSN, APRN, FNP-C
• Esther Grace Pablo Kanayjorn, MD
• Kellis Home
• Kellis Home LLC

• All providers in Greenfield, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.