Individual provider Active NPI

Raeshauna Johnson, NP

  • Primary Care Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1003679804
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
227318 Issued in AR
Practice address
8 Wild Berry PL
Little Rock, AR 72210-5653
Phone
(501) 478-1504
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 227318 AR Primary

Addresses

Primary practice location

8 Wild Berry PL
Little Rock, AR 72210-5653

Mailing address

8 Wild Berry PL
Little Rock, AR 72210-5653
Phone (501) 478-1504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20240727000406 AR Practitioner - Nurse Practitioner 0941746838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Curana Health of Arkansas LLCGroup PAC ID 1658684675, 12 clinicians

Practice addresses (Care Compare)

609 SW 8TH St
6TH Floor
Bentonville, AR 72712-8913
Phone (337) 991-9276

Hospital & facility affiliations

  • Care IV Home Health Home health agency, Little Rock, AR, CCN 047178

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BL Physician Home Care Solutions PLLC CurrentSince Jul 1, 2024 Accepting new patients
Curana Health of Arkansas LLC CurrentSince Mar 4, 2025 Accepting new patients

Locations

117 S Market St
Ste 217
Benton, AR 72015
Phone (430) 200-4350

609 SW 8th St
Fl 6
Bentonville, AR 72712
Phone (479) 349-2579

609 SW 8th St
#6
Bentonville, AR 72712

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1003679804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILD BERRY PL",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105653",
            "telephone_number": "501-478-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WILD BERRY PL",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105653",
            "telephone_number": "501-478-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RAESHAUNA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "227318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.