Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Johnson

Individual provider Family Nurse Practitioner · NPI 1336973767

Ethan Johnson is a Nurse Practitioner in Louisville, Kentucky. Qualified in 2024, 2 years ago. Practices with Baptist Health Medical Group Inc, a 2,445-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
2
Licensed in
KY
In the registry since
2024
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Practice location Address checks out

3900 Kresge Way Ste 60
Louisville, KY 40207-4690
Phone: (502) 897-8008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4024171 (KY)

Record details

NPI number1336973767
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 28, 2024
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Baptist Health Medical Group Inc — 2445 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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