NPIMap

Individual provider Active NPI

Ashley Johnson

  • Family Nurse Practitioner
  • Kilgore, TX
National Provider Identifier
1275298317
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1057519 Issued in TX
Practice address
1718 S Henderson Blvd
Kilgore, TX 75662-3544
Phone
(903) 983-2110
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1057519 TX
Family Nurse Practitioner 363LF0000X 1057519 TX Primary

Addresses

Primary practice location

1718 S Henderson Blvd
Kilgore, TX 75662-3544

Mailing address

1718 S Henderson Blvd
Kilgore, TX 75662-3544
Phone (903) 983-2110

Other practice location 1

223 Robyn Ln
Longview, TX 75605-6721
Phone (903) 241-2989

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ashley.johnson3@christushealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220526002349 TX Practitioner - Nurse Practitioner 5193103471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic Texas 1,540 clinicians

Practice addresses (Care Compare)

1614 S Henderson Blvd
Suite a
Kilgore, TX 75662-3518
Phone (903) 983-2110

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1057519TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Apr 25, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 25, 2022 Accepting new patients

Locations

1718 S Henderson Blvd
Kilgore, TX 75662
Phone (903) 983-2110

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: ajohnson216953@christushealth.direct-ci.net

Organizations & group practices 9

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 2

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1275298317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 S HENDERSON BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623544",
            "telephone_number": "903-983-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 S HENDERSON BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623544",
            "telephone_number": "903-983-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Robyn Ln",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756056721",
            "country_code": "US",
            "telephone_number": "903-241-2989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1057519",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1057519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ashley.johnson3@christushealth.org",
            "affiliation": "N",
            "address_1": "1718 S Henderson Blvd",
            "city": "Kilgore",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756623544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kilgore, TX

Sources for this page

Verify at the official NPI Registry.