Individual provider Active NPI

Mikqenya Johnson, NP

  • Nurse Practitioner
  • Alexandria, LA
National Provider Identifier
1609548213
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
207723 Issued in LA
Practice address
201 4TH St Ste 5a
Alexandria, LA 71301-8421
Phone
(318) 512-2804
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 207723 LA Primary

Addresses

Primary practice location

201 4TH St Ste 5a
Alexandria, LA 71301-8421

Mailing address

201 4TH St Ste 5a
Alexandria, LA 71301-8421
Phone (318) 512-2804

Other identifiers 1

IdentifierTypeStateIssuer
123MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20211020002000 LA Practitioner - Nurse Practitioner 1658769856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hni Medical Services at Glenwood LLCGroup PAC ID 0547518920, 9 clinicians

Practice addresses (Care Compare)

5980 Cherry Ridge Rd
Bastrop, LA 71220-1842
Phone (318) 281-6933

Hospital & facility affiliations

  • Alphacare Home Health, Inc. Home health agency, Monroe, LA, CCN 197491
  • Haven Home Health Inc Home health agency, Monroe, LA, CCN 197210
  • Serenity Homecare Home health agency, West Monroe, LA, CCN 197296
  • Glenwood Regional Medical Center Hospital, West Monroe, LA, CCN 190160

Merit-based Incentive Payment System (MIPS)

Final score
89.56 of 100Reported as group
Quality
76.8
Improvement activities
40
Cost
74.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services at Glenwood, LLC Nurse Practitioner CurrentSince Oct 1, 2022 Accepting new patients

Locations

5980 Cherry Ridge Rd
Bastrop, LA 71220
Phone (318) 281-6933

503 McMillan Rd
West Monroe, LA 71291
Phone (318) 329-4200

1616 Wellerman Rd
West Monroe, LA 71291
Phone (318) 387-2577

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Organizations & group practices 1

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 4

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1609548213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 4TH ST STE 5A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-512-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 4TH ST STE 5A",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-512-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIKQENYA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "207723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.