NPIMap

Individual provider Active NPI

Heather Todd Johnson, FNP

  • Family Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1710749072
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77209 Issued in NM
Practice address
4801 Beckner Rd Ste 1700
Santa Fe, NM 87507-3641
Phone
(505) 772-2000
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77209 NM
Family Nurse Practitioner 363LF0000X 77209 NM Primary

Addresses

Primary practice location

4801 Beckner Rd Ste 1700
Santa Fe, NM 87507-3641

Mailing address

PO Box 2581
Tijeras, NM 87059-2581
Phone (505) 440-5665

Other practice location 1

1316 Jackie Rd SE Ste 500
Rio Rancho, NM 87124-6607
Phone (505) 415-0719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419003514 NM Practitioner - Nurse Practitioner 5193164366 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4801 Beckner Rd
Santa Fe, NM 87507-3641
Phone (505) 772-1677

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77209NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
G & M Medical Center CurrentSince May 31, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Apr 23, 2024 Accepting new patients
G & M Medical Center LLC Family Medicine CurrentSince Mar 12, 2024 Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Apr 23, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1316 Jackie Rd SE
Ste 400
Rio Rancho, NM 87124
Phone (505) 234-1612

1316 Jackie Rd SE
Ste 500
Rio Rancho, NM 87124
Phone (505) 415-0719

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

4801 Beckner Rd
Ste 1700
Santa Fe, NM 87507
Phone (505) 772-1730

Interoperability endpoints

  • Direct secure messaging: hjohnson115910@direct.phs.org

Organizations & group practices 5

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1710749072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2581",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870592581",
            "telephone_number": "505-440-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 BECKNER RD STE 1700",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073641",
            "telephone_number": "505-772-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1316 Jackie Rd SE Ste 500",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871246607",
            "country_code": "US",
            "telephone_number": "505-415-0719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "TODD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "77209",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "77209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.