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

Mallory Brooke Johnson, NP

Individual provider Family Nurse Practitioner · NPI 1518520238

Mallory Brooke Johnson, NP is a Nurse Practitioner in Charlotte, North Carolina. Qualified in 2019, 7 years ago. Practices with Novant Health Medical Group Coastal Region LLC, a 576-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2019
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

125 Queens Rd Ste 610
Charlotte, NC 28204-3580
Phone: (980) 302-6600
Fax: (980) 302-6605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5011691 (NC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 5011691 (NC)

Record details

NPI number1518520238
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 18, 2019
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Novant Health Medical Group Coastal Region Llc — 576 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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