NPIMap

Individual provider Active NPI

Kayla Renee Johnson, APRN

  • Family Nurse Practitioner
  • Conway, AR
National Provider Identifier
1255839858
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R093505 Issued in AR
Practice address
655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
Phone
(501) 209-4040
Fax
(501) 205-1776
NPI assigned
Jan 29, 2018
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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 R093505 AR Primary

Addresses

Primary practice location

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145

Mailing address

655 Dave Ward Dr Ste 103
Conway, AR 72034-7145
Phone (501) 209-4040

Other identifiers 1

IdentifierTypeStateIssuer
F12170822OtherTXAANP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180309001808 AR Practitioner - Nurse Practitioner 0648531590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noydeen Sisters Medical Group and Clinics IncGroup PAC ID 7618260092, 9 clinicians

Practice addresses (Care Compare)

655 Dave Ward Dr
Suite 103
Conway, AR 72034-7145
Phone (501) 209-4040

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1255839858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DAVE WARD DR STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347145",
            "telephone_number": "501-209-4040",
            "fax_number": "501-205-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAYLA",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "R093505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "F12170822",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.