Individual provider Active NPI

Jessica Joann Johnson, FNP - BC

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1114308707
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004367 Issued in AR
Practice address
6924 Geyer Springs Rd
Little Rock, AR 72209-2728
Phone
(501) 562-1463
Fax
(501) 803-9991
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004367 AR Primary

Addresses

Primary practice location

6924 Geyer Springs Rd
Little Rock, AR 72209-2728

Mailing address

6924 Geyer Springs Rd
Little Rock, AR 72209-2728
Phone (501) 562-1463

Other names 1

  • Jessica Joann Stevens Former name

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
I20150917002194 AR Practitioner - Nurse Practitioner 2062729494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 Broadmoor Dr
Mountain Home, AR 72653-2903

Hospital & facility affiliations

  • Elite Home Health Home health agency, Salem, AR, CCN 047115
  • Baxter Health Hospital, Mountain Home, AR, CCN 040027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter County Regional Hospital, Inc CurrentSince Feb 25, 2019 Accepting new patients
Baxter County Regional Hospital, Inc CurrentSince Feb 25, 2019 Accepting new patients
Southwest Family Practice PA CurrentSince Apr 6, 2016 Accepting new patients
Baxter County Regional Hospital, Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

6924 Geyer Springs Rd
Little Rock, AR 72209
Phone (501) 562-1463

624 Hospital Dr
Mountain Home, AR 72653
Phone (870) 424-1000

Interoperability endpoints

  • Direct secure messaging: jessica.johnson@bhcawp.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1114308707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 GEYER SPRINGS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092728",
            "telephone_number": "501-562-1463",
            "fax_number": "501-803-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 GEYER SPRINGS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092728",
            "telephone_number": "501-562-1463",
            "fax_number": "501-803-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "FNP - BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STEVENS",
            "middle_name": "JOANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.