Individual provider Active NPI

Eloise Johnns, ARNP

  • Family Nurse Practitioner
  • Oxnard, CA
National Provider Identifier
1689097461
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60445517 Issued in WA
Practice address
2651 S C St
Oxnard, CA 93033-3560
Phone
(805) 983-6713
NPI assigned
Jan 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60445517 WA Primary

Addresses

Primary practice location

2651 S C St
Oxnard, CA 93033-3560

Mailing address

PO Box 14
Laclede, ID 83841-0014
Phone (509) 344-9727

Other practice location 1

13318 E Sprague Ave
Spokane Valley, WA 99216-0846
Phone (509) 928-2406

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220317002306 TX Practitioner - Nurse Practitioner 9830320191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians

Practice addresses (Care Compare)

1600 S Henderson Blvd
Kilgore, TX 75662-3518
Phone (903) 758-1818

Hospital & facility affiliations

  • White Rock Medical Center Hospital, Dallas, TX, CCN 450678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60445517WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Management Specialists, LLC CurrentSince Jul 1, 2023 Accepting new patients
Lags Spine and Sportscare Medical Centers, Inc. Past Accepting new patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients
Universal Healthcare Professional Medical PC PastSince Sep 9, 2016 Accepting new patients
Lags Spine and Sportscare Medical Centers Inc Past Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

434 Katherine Dr
Flowood, MS 39232
Phone (769) 216-3346

1600 S Henderson Blvd
Kilgore, TX 75662
Phone (903) 215-3149

515 N 3rd St
Longview, TX 75601
Phone (903) 215-3149

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 6

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": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1689097461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "LACLEDE",
            "state": "ID",
            "postal_code": "838410014",
            "telephone_number": "509-344-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 S C ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333560",
            "telephone_number": "805-983-6713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13318 E Sprague Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992160846",
            "country_code": "US",
            "telephone_number": "509-928-2406",
            "fax_number": "509-928-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNNS",
        "first_name": "ELOISE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60445517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.