Individual provider Active NPI

Zandra Kay Johnson, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1710223995
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002285 Issued in NV
Practice address
7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone
(702) 243-8500
Fax
(702) 363-8753
NPI assigned
Dec 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22620 CA
Family Nurse Practitioner 363LF0000X APRN002285 NV Primary

Addresses

Primary practice location

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20161020000245 NV Practitioner - Nurse Practitioner 2769619493 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians
Urgent Care Nevada LLCGroup PAC ID 7012137037, 106 clinicians

Practice addresses (Care Compare)

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2716 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2845 Siena Heights Dr
Henderson, NV 89052-4153
Phone (702) 579-3253

420 N Nellis Blvd
Las Vegas, NV 89110-5364
Phone (702) 579-3253

4475 S Eastern Ave
Las Vegas, NV 89119-7826
Phone (702) 579-3253

6440 Centennial Ctr Blvd
Suite 110
Las Vegas, NV 89149-4797
Phone (702) 901-8320

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22620CAMDFamily Nurse Practitioner
APRN002285NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Jun 9, 2019 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Southwest Medical Associates, Inc CurrentSince Oct 31, 2016 Accepting new patients

Locations

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

4348 E Craig Rd
Las Vegas, NV 89115

7061 Grand Montecito Pkwy
Las Vegas, NV 89149
Phone (702) 750-3800

3150 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 220-9865

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

4475 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 669-5811

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

Interoperability endpoints

  • Direct secure messaging: zjohnson120882@westdirect.optum.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1710223995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5153",
            "fax_number": "702-258-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7061 GRAND MONTECITO PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490287",
            "telephone_number": "702-243-8500",
            "fax_number": "702-363-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ZANDRA",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22620",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.