Nicklett R Johnston, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

546098 Issued in TX

Practice address

688 W 4TH St Ste B
Benson, AZ 85602

Phone

(520) 720-6551

Fax

(520) 720-6552

NPI assigned

Feb 15, 2007

Last updated

Aug 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Benson Hospital Corporation

  • Critical Access Hospital
  • Benson, AZ
  • NPI 1336118322
  Medicare reassignment NPD
• Texas Physicians Primary Care, PLLC

  • Family Medicine Physician
  • Mesquite, TX
  • NPI 1962800284
  Medicare reassignment NPD
• Benson Hospital Corporation

  • Rural Health Clinic/Center
  • Vail, AZ
  • NPI 1457924920
  NPD
• Texas Physicians Primary Care, PLLC

  • Family Medicine Physician
  • Grand Prairie, TX
  • NPI 1417403957
  NPD
• Benson Hospital Corporation

  • Rural Health Clinic/Center
  • Benson, AZ
  • NPI 1205327582
  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1356484596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 W 4TH ST STE B",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026315",
            "telephone_number": "520-720-6551",
            "fax_number": "520-720-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 W 4TH ST STE B",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "85602",
            "telephone_number": "520-720-6551",
            "fax_number": "520-720-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 E President George Bush Hwy Ste 107",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750823565",
            "country_code": "US",
            "telephone_number": "214-691-2975",
            "fax_number": "214-691-2967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "NICKLETT",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "546098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184626301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184626302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184626303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healing Ways PLLC (San Pedro chiropractic)
• Healthcare Innovations Inc.
• Debra A Heaton, LISAC
• Alina Michele Hernandez
• Diana R Housley
• Linda Beth Judd, DC
• Cassandra Keith, RN
• Lisa Dawn Kesling, RPH
• Lazy Horse Ranch
• Helen Sue Leclair, MPT

• Family Nurse Practitioner in Benson, AZ
• Providers in Benson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.