Individual provider Active NPI

Marva J Johnston, RNCNP

  • Women's Health Nurse Practitioner
  • Hobbs, NM
National Provider Identifier
1679601884
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R25079 Issued in NM
Practice address
5419 N Lovington Hwy
Suite 25
Hobbs, NM 88240-9100
Phone
(575) 392-0077
Fax
(575) 392-3925
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R25079 NM Primary

Addresses

Primary practice location

5419 N Lovington Hwy
Suite 25
Hobbs, NM 88240-9100

Mailing address

PO Box 92
Hobbs, NM 88241-0092
Phone (575) 392-0077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20121128000241 NM Practitioner - Nurse Practitioner 7517119415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

2000 W 21St St
Suite W7
Clovis, NM 88101-1402
Phone (575) 763-3666

5320 N Lovington Hwy
Hobbs, NM 88240-9139
Phone (575) 392-1973

Hospital & facility affiliations

  • Covenant Health Hobbs Hospital Hospital, Hobbs, NM, CCN 320065
  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Covenant Medical Group CurrentSince Jan 1, 2021 Accepting new patients

Locations

2000 W 21st St
Ste W7
Clovis, NM 88101
Phone (575) 637-7000

5419 N Lovington Hwy
Ste 29
Hobbs, NM 88240
Phone (575) 392-0077

5419 N Lovington Hwy
Ste 31
Hobbs, NM 88240
Phone (575) 392-3200

Interoperability endpoints

  • Direct secure messaging: mjohnston2018561@oc.providencedirect.org

Organizations & group practices 2

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 2

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1679601884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882410092",
            "telephone_number": "575-392-0077",
            "fax_number": "575-392-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 N LOVINGTON HWY",
            "address_2": "SUITE 25",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882409100",
            "telephone_number": "575-392-0077",
            "fax_number": "575-392-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MARVA",
        "middle_name": "J",
        "credential": "RNCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "R25079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobbs, NM

Sources for this page

Verify at the official NPI Registry.