NPIMap

Individual provider Active NPI

Johnathan David Steele, MS, MMS, LPC, PA-C

  • Physician Assistant
  • Texarkana, AR
National Provider Identifier
1336237635
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-296 Issued in AR
Practice address
2904 Arkansas Blvd
Texarkana, AR 71854-2536
Phone
(870) 773-4655
Fax
(870) 772-4650
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 57816 TX
Physician Assistant 363A00000X PA-296 AR Primary
Physician Assistant 363A00000X PA050593 TX

Addresses

Primary practice location

2904 Arkansas Blvd
Texarkana, AR 71854-2536

Mailing address

2904 Arkansas Blvd
Texarkana, AR 71854-2536
Phone (870) 773-4655

Other identifiers 1

IdentifierTypeStateIssuer
440146301MedicaidAR

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
I20070417000330 TX Practitioner - Physician Assistant 1850493248 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone (903) 614-5250

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

Hospital & facility affiliations

  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
57816TXMDProfessional Counselor
PA-296ARMDPhysician Assistant
PA050593TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jul 5, 2021 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 5, 2021 Accepting new patients
Four States Emergency Physicians Past Accepting new patients
Exceed Health Clinic PastSince Feb 21, 2021 Accepting new patients

Locations

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6966/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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 3

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336237635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542536",
            "telephone_number": "870-773-4655",
            "fax_number": "870-772-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542536",
            "telephone_number": "870-773-4655",
            "fax_number": "870-772-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEELE",
        "first_name": "JOHNATHAN",
        "middle_name": "DAVID",
        "credential": "MS, MMS, LPC, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "57816",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-296",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA050593",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440146301",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.