Individual provider Active NPI

Kandice Nicole Hunter, APRN, AGNP

  • Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1003476144
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
206498 Issued in LA
Practice address
4864 Jackson St
Monroe, LA 71202-6400
Phone
(318) 330-7000
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 206498 LA Primary

Addresses

Primary practice location

4864 Jackson St
Monroe, LA 71202-6400

Mailing address

116 Savannah St
Monroe, LA 71202-3922
Phone (318) 537-3056

Other names 1

  • Kandice Nicole Johnson-Hunter Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111002624 LA Practitioner - Nurse Practitioner 2365852803 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
206498LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brfhh Monroe LLC CurrentSince Nov 9, 2020 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Jul 1, 2021 Accepting new patients
Brfhh Monroe LLC CurrentSince Nov 9, 2020 Accepting new patients
Prohealth Monroe, LLC Current Accepting new patients
University Health Shreveport LLC Nurse Practitioner CurrentSince Nov 9, 2020 Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEBGBA/Endpoint/JEBGBA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1003476144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SAVANNAH ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712023922",
            "telephone_number": "318-537-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "KANDICE",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "APRN, AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "206498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANDICE",
            "last_name": "JOHNSON-HUNTER",
            "middle_name": "NICOLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.