Johnny Villanueva Agustin, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95018599 Issued in CA

Practice address

565 Kern St
Shafter, CA 93263-2133

Phone

(661) 746-4937

NPI assigned

Nov 21, 2007

Last updated

Dec 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vanguard Medical Corporation

  dba Shafter Rural Healthcare Clinic

  • Rural Health Clinic/Center
  • Shafter, CA
  • NPI 1609281310
  Medicare reassignment NPD
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Wasco, CA
  • NPI 1164270807
  NPD
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Wasco, CA
  • NPI 1558801829
  NPD

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1174704845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BRIGHTSTONE DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933127032",
            "telephone_number": "661-333-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 KERN ST",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632133",
            "telephone_number": "661-746-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "JOHNNY",
        "middle_name": "VILLANUEVA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-21",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018599",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "536811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aa Medical Transport Inc
• Adventist Health Physicians Network
• Vanessa Alba
• Brittany Alford, IDMT
• Nathan Carl Allen, P.A.
• Art of Serenity Inc (Sandra Demmin Wellness Center)
• Av Elite Medical LLC

• Nurse Practitioner in Shafter, CA
• Providers in Shafter, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.