Mrs Khatriena D Johnson, APRN is a medicare enrolled "Counselor - Mental Health" in Melbourne, Florida. Her current practice location is
2020 Commerce Dr, Melbourne, Florida. You can reach out to her office (for appointments etc.) via phone at
(321) 952-6000.
Mrs Khatriena D Johnson is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1306557798.
Provider's Profile
| Full Name | Mrs Khatriena D Johnson |
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| Gender | Female |
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| Speciality | Counselor - Mental Health |
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| Location | 2020 Commerce Dr, Melbourne, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1306557798
- Provider Enumeration Date: 12/07/2022
- Last Update Date: 02/14/2023
Medicare PECOS Information:
- PECOS PAC ID: 5698144426
- Enrollment ID: I20230211000196
Medical Identifiers
Medical identifiers for Mrs Khatriena D Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1306557798 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APRN11023333 (Florida) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Khatriena D Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Circles Of Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215345954 PECOS PAC ID: 8729069380 Enrollment ID: O20040528000379 |
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| Entity Name | Grow Healthcare Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
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| Entity Name | Mindset & Recovery Diversified Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518792365 PECOS PAC ID: 9032650486 Enrollment ID: O20240926000123 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Khatriena D Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mrs Khatriena D Johnson, APRN 400 E Sheridan Rd, Melbourne, FL 32901-3184 Ph: (321) 722-5200 | Mrs Khatriena D Johnson, APRN 2020 Commerce Dr, Melbourne, FL 32904-2335 Ph: (321) 952-6000 |
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