DR. CARRIE LYNN JOHNSON M.D. NPI 1174525091

NPI Information

NPI: 1174525091
Provider Name: DR. CARRIE LYNN JOHNSON, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 1138 COUNTRY CLUB BLVD
CAPE CORAL, FL
ZIP 33990
Phone: (239) 424-1900

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NPI Details

DR. Carrie Lynn Johnson, M.D. is an obstetrics gynecology in Cape Coral, FL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Carrie Lynn Johnson, M.D. NPI is 1174525091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1138 COUNTRY CLUB BLVD
CAPE CORAL, FL
ZIP 33990-027
Phone: (239) 424-1900
Fax: (239) 424-1904

The NPI 1174525091 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 8/11/2005 and was last updated on 5/9/2025.

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	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology	MD189072	OREGON	No
2	207V00000X	Obstetrics & Gynecology	MD61550112	WASHINGTON	No
3	207V00000X	Obstetrics & Gynecology	ME102875	FLORIDA	Yes
4	207V00000X	Obstetrics & Gynecology	036090783	ILLINOIS	No

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
1	008052600	MEDICAID	FLORIDA
2	3025372	MEDICAID	OHIO
3	119355500	MEDICAID	FLORIDA

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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