ROGER DALE JOHNSON FNP NPI 1215975362

NPI Information

  • NPI: 1215975362
  • Provider Name: ROGER DALE JOHNSON, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 207 E MYRTLE AVE
    JOHNSON CITY, TN
    ZIP 37601
  • Phone: (423) 925-2600

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NPI Details

Roger Dale Johnson, FNP is a family nurse practitioner in Johnson City, TN. Roger Dale Johnson, FNP NPI is 1215975362. 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:

207 E MYRTLE AVE
JOHNSON CITY, TN
ZIP 37601-633
Phone: (423) 925-2600
Fax: (423) 925-2600

The NPI 1215975362 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2006 and was last updated on 4/30/2008.

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
1363LF0000XNurse PractitionerFamilyTN11991TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13643768MEDICARE OSCAR/CERTIFICATION
23643768MEDICARE PINTENNESSEE
3Q71587MEDICARE UPIN
43643768MEDICAIDTENNESSEE

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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