MARY AGNES JOHNSON (NPI# 1003251539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003251539 |
| Entity Type | Individual |
| Full Name | MARY AGNES JOHNSON |
| Credential | NP |
| Practice Address |
1400 8th Ave Fort Worth TX 76104-4110 |
| Mailing Address |
2900 Willing Ave Fort Worth TX 76110-3446 |
| Practice Telephone | 8179227070 |
| Mailing Telephone | 3347440554 |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 834891 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953145 | Mary Ann Johnson | Technician | 165 Everett Dr, Gallipolis Ferry, WV 25515-7005 | 2020-08-21 |
| 1851938385 | Mary Johnson | Technician | 2917 W 19th Ave Trlr 79, Kennewick, WA 99337-2307 | 2019-12-03 |
| 1578106845 | Mary Margaret Johnson | Social Worker | 6614 Shallowford Rd. Suite 250, Lewisville, NC 27023 | 2019-10-19 |
| 1033670807 | Mary Bernece Johnson | Registered Nurse | 5603 Mandalay, Killeen, TX 76549-4597 | 2019-03-26 |
| 1295205342 | Mary Elizabeth Johnson | Speech-Language Pathologist | 502 W Windsor Rd, Champaign, IL 61820-7739 | 2018-12-03 |
| 1255825758 | Mary Elizabeth Johnson | Dietitian, Registered | 3590 Lucille Dr Ste 2600, Cincinnati, OH 45213-2669 | 2018-06-18 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1841735289 | Mary Johnson | Registered Nurse | 14 Cypress Fairway Vlg, Wimberley, TX 78676-1974 | 2016-12-20 |
| 1467827220 | Mary Johnson | Registered Nurse | 308 Keelson Dr, Detroit, MI 48215-3058 | 2015-12-04 |
| 1003286055 | Mary Ann Johnson | Dentist | 320 Comanche St., Kiowa, CO 80117 | 2015-10-02 |
| Street Address |
1400 8TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393674 | Todd Ryan Newton | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-10-13 |
| 1477163749 | Sarah Louise Kelley | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-08-03 |
| 1659980811 | Jessica Marie Custance | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-07-23 |
| 1912516170 | Kevin Pannell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-07-23 |
| 1093336570 | Lindsay Keller Chapman | Physical Therapist | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-05-06 |
| 1093336752 | Joab Odhiambo Acholla | Nurse Practitioner | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-05-04 |
| 1952937823 | Melissa Maxwell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-03-22 |
| 1700419421 | Jaclyn Theresa Channell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-02-20 |
| 1245861160 | Landon Collier | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-01-29 |
| 1245861178 | Brittney Long | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940837 | Katherine Anna Nack | Nurse Practitioner | 6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127 | 2020-10-26 |
| 1588299077 | Godling Obi Onyegbunwa | Nurse Practitioner | 4200 South Fwy Ste 106, Fort Worth, TX 76115-1407 | 2020-03-05 |
| 1700423233 | Complex Healthcare Solutions, LLC | Nurse Practitioner | 6040 Camp Bowie Blvd Ste 24, Fort Worth, TX 76116-5602 | 2019-12-03 |
| 1689149858 | Teresa Leverenz | Nurse Practitioner | 5751 Edwards Ranch Rd, Fort Worth, TX 76109-4120 | 2018-10-03 |
| 1972094779 | Damita Jo Jones | Nurse Practitioner | 8450 East Fwy, Fort Worth, TX 76120-4413 | 2018-05-29 |
| 1548750136 | Bianca Maria Armstrong | Nurse Practitioner | 4364 Heritage Trace Pkwy Ste 104, Fort Worth, TX 76244-9125 | 2018-05-18 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1225542855 | Alicia Marie Segovia | Nurse Practitioner | 6100 Harris Pkwy Ste 340, Fort Worth, TX 76132-4133 | 2017-11-17 |
| 1083137202 | Jordan Deneen Costlow | Nurse Practitioner | 1250 8th Ave Ste 435, Fort Worth, TX 76104-4144 | 2017-07-19 |
| 1558884809 | Tambra B Guinn | Nurse Practitioner | 2300 Circle Dr Ste 2307, Fort Worth, TX 76119-8134 | 2017-07-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.