Connie Denise Johnson-Wiltz, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

703409 Issued in TX

Practice address

2933 Park Plaza LN
Port Arthur, TX 77642-5516

Phone

(409) 983-1899

Fax

(409) 300-4310

NPI assigned

Jan 12, 2018

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pulse Homecare LTD Home health agency, Beaumont, TX, CCN 457884
• Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034

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 and National Provider Directory roles.

• Complete Health Care

  • Family Nurse Practitioner
  • Port Arthur, TX
  • NPI 1316610017
  Medicare reassignment NPD Authorized official
• Ukanti Healthcare Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Arthur, TX
  • NPI 1114769023
  NPD
• Ab Genuine Health, LLC

  • Family Medicine Physician
  • Nederland, TX
  • NPI 1568091072
  NPD (past)
• Gulf Coast Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Port Arthur, TX
  • NPI 1205275054
  NPD (past)

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

• Christus Health Southeast Texas

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1679557888
  Care Compare affiliation
• Pulse Homecare, LTD.

  • Home Health Agency
  • Beaumont, TX
  • NPI 1548279888
  Care Compare affiliation

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1306354261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 PARK PLAZA LN",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776425516",
            "telephone_number": "409-983-1899",
            "fax_number": "409-300-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 PARK PLAZA LN",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776425516",
            "telephone_number": "409-983-1899",
            "fax_number": "409-300-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-WILTZ",
        "first_name": "CONNIE",
        "middle_name": "DENISE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "703409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• June Lynette Jennings, LVN
• Jerry L Philmon
• Fareesha Jiwani, PA
• John a Iceton MD PA
• John H. Lee DO, PA
• Cathy A Johnson
• Melinda Kay Johnson, LPC
• Tyler Johnson, PHARM D
• Gene E. Jones, M.D.
• Rakesha Jones, PHARMD

• Family Nurse Practitioner in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.