Individual provider Active NPI

Angela Jo Johnson, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1982958229
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007832 Issued in KY
Practice address
9340 Cedar Center Way
Louisville, KY 40291-4522
Phone
(502) 239-8431
Fax
(502) 239-8399
NPI assigned
Nov 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3007832 KY
Family Nurse Practitioner 363LF0000X 3007832 KY Primary

Addresses

Primary practice location

9340 Cedar Center Way
Louisville, KY 40291-4522

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 3

IdentifierTypeStateIssuer
7100242780MedicaidKY
147633OtherKYSIHO - NICC
000000819545OtherKYANTHEM - NICC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130506000495 KY Practitioner - Nurse Practitioner 1254578503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4801 Olympia Park PLZ
Suite 2200
Louisville, KY 40241-8171
Phone (502) 423-9595

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3007832KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince May 1, 2013 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince May 1, 2013 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients

Locations

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

4801 Olympia Park Plz
Ste 2200
Louisville, KY 40241
Phone (502) 423-9595

7926 Preston Hwy
Ste 106
Louisville, KY 40219
Phone (502) 964-4357

9340 Cedar Center Way
Louisville, KY 40291
Phone (502) 239-8431

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: ajohnson59664@direct.nortonhealthcare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1982958229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 CEDAR CENTER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914522",
            "telephone_number": "502-239-8431",
            "fax_number": "502-239-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELA",
        "middle_name": "JO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100242780",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - NICC",
            "identifier": "147633",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NICC",
            "identifier": "000000819545",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.