Jessica Renee Johnson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP136374 Issued in TX

Practice address

1379 Brad Cir
Lindale, TX 75771-6666

Phone

(903) 881-5165

NPI assigned

Jan 31, 2018

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

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tyler Internal Medicine Associates, P.aGroup PAC ID 3476541731, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.johnson@tima.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/ADCFBA

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.

• Tyler Internal Medicine Associates, P.a.

  • Internal Medicine Physician
  • Tyler, TX
  • NPI 1770695850
  Medicare reassignment Care Compare group NPD

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

• Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Tyler, TX
  • NPI 1174021695

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1528566924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19927 COUNTY ROAD 445",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757713500",
            "telephone_number": "972-762-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 BRAD CIR",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757716666",
            "telephone_number": "903-881-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunters Compassionate Care LLC
• Icon Medical Solutions Inc.
• In-Hale LLC
• Amber Breann James, NP
• Elizabeth Anne Johnson
• Raul Johnson III, DVM
• Raymond F Jordan, DO
• K Kids Therapy
• Kathryn D. Ketter (Snider Adult Foster Care)
• Baron Clay Keith, D.D.S.

• Family Nurse Practitioner in Lindale, TX
• Providers in Lindale, 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 Jan 31, 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.
• 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.