NATHANIEL JOHNSON PMHNP-BC NPI 1124715222

NPI Information

  • NPI: 1124715222
  • Provider Name: NATHANIEL JOHNSON, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2613 W HENRIETTA RD STE F
    ROCHESTER, NY
    ZIP 14623
  • Phone: (585) 702-2612

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NPI Details

Nathaniel Johnson, PMHNP-BC is a psychiatric/mental health nurse practitioner in Rochester, NY. Nathaniel Johnson, PMHNP-BC NPI is 1124715222. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2613 W HENRIETTA RD STE F
ROCHESTER, NY
ZIP 14623-327
Phone: (585) 702-2612

The NPI 1124715222 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/19/2023 and was last updated on 3/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse758875NEW YORKNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health404969NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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