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

Tyla Aliece Johnson, FNP-C

Individual provider Family Nurse Practitioner · NPI 1457842213

Tyla Aliece Johnson, FNP-C is a Nurse Practitioner in Bridgeton, Missouri. Practices with SSM Medical Group Inc, a 560-clinician group and accepts Medicare assignment. Licensed in Missouri.

Licensed in
MO
In the registry since
2018
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

12255 De Paul Dr Ste 600
Bridgeton, MO 63044-2515
Phone: (314) 209-5100
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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 2018004082 (MO)

Record details

NPI number1457842213
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedMay 28, 2018
Last updated in NPPESOctober 22, 2020
Certification dateOctober 22, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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