Johannah Renee Yazzie, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CNP-03377 Issued in NM

Practice address

85 W Highway 22
Santo Domingo Pueblo, NM 87052-1283

Phone

(505) 465-3060

Fax

(505) 591-0304

NPI assigned

Sep 15, 2017

Last updated

Oct 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johannah.yazzie.p1@direct.kp-hc.nextgenshare.com
• Direct secure messaging: jyazzie255120@direct.phs.org

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

• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888

  TX

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Phoenix Indian Medical Center

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Ak-Chin Clinic

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1164941621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520340",
            "telephone_number": "505-465-3060",
            "fax_number": "505-591-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W HIGHWAY 22",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870521283",
            "telephone_number": "505-465-3060",
            "fax_number": "505-591-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 Las Estancias Dr SW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871215504",
            "country_code": "US",
            "telephone_number": "505-555-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZZIE",
        "first_name": "JOHANNAH",
        "middle_name": "RENEE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "CNP-03377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal J Tortalita
• Soren Uhl, RN
• Janet Reyes Vega, RN
• Timothy W Watkins, LCSW
• Yu Jin Williams, RN
• Kaitlyn Yepa, RN

• Pediatric Nurse Practitioner in Santo Domingo Pueblo, NM
• Providers in Santo Domingo Pueblo, NM by specialty
• Pediatric Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.