ETHAN JOHNSON
NPI 1336973767
Nurse Practitioner - Family in Louisville, KY

Q: What is Ethan Johnson's NPI number?

The NPI number for Ethan Johnson is 1336973767. It was assigned to this individual provider in the NPPES registry on August 28, 2024.

Q: What is Ethan Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Johnson was last updated on August 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 28, 2024PECOS EnrolledAccepts Medicare Assignment

3900 KRESGE WAY STE 60, LOUISVILLE, KY 40207(502) 897-8008 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Ethan Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN JOHNSON (NPI 1336973767) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (4024171) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Floyd, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1336973767

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameETHAN JOHNSON

Location Address3900 KRESGE WAY STE 60Louisville, KY 40207-4690

Mailing Address3900 Kresge WayLouisville, KY 40207-4660

Phone(502) 897-8008

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 28, 2024

NPPES CertifiedAugust 28, 2024

✔ NPI 1336973767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 4024171

3900 KRESGE WAY STE 60, Louisville, KY 40207

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Johnson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113459777

PECOS Enrollment IDI20241021002208

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

28 services28 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

26 services26 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Floyd

Acute Care Hospitals · New Albany, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150044

Location1850 State StNew Albany, IN 47150 · Floyd County

Emergency services Birthing friendly

Baptist Health Hardin

Acute Care Hospitals · Elizabethtown, KY

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number180012

Location913 North Dixie AvenueElizabethtown, KY 42701 · Hardin County

Emergency services

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180130

Location4000 Kresge WayLouisville, KY 40207 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40207 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA ERIN CHELF APRN, DNP, FNP-C

Nurse Practitioner