Jody Johnson, APRN
Nurse Practitioner, Family in Melbourne, FL. Individual provider (NPI-1).
NPI number1962035667
StatusActive
Last updated in NPPESFeb 20, 2020
Details
- NPI
- 1962035667
- Entity type
- Individual (NPI-1)
- Name
- Jody Johnson
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 20, 2020
- Certification date
- Feb 20, 2020
- Last updated
- Feb 20, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11005397 | FL | Yes |
Practice location
1341 Bedford DrMelbourne, FL 32940-1986
Phone 321-622-8031
Mailing address
1341 Bedford DrMelbourne, FL 32940-1986
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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