Individual provider Active NPI

Leslie Hunter-Johnson, APRN

  • Gerontology Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1770955270
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN002142 Issued in NV
Practice address
504 Heritage Bridge Ave
Henderson, NV 89011-2670
Phone
(702) 328-3112
NPI assigned
Oct 22, 2015
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN002142 NV
Gerontology Nurse Practitioner 363LG0600X APRN002142 NV Primary

Addresses

Primary practice location

504 Heritage Bridge Ave
Henderson, NV 89011-2670

Mailing address

504 Heritage Bridge Ave
Henderson, NV 89011-2670
Phone (702) 328-3112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220117000229 WA Practitioner - Nurse Practitioner 2466747894 Reassigns benefits to 3 organizations
I20220215000186 ID Practitioner - Nurse Practitioner 2466747894 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Pac Services PCGroup PAC ID 4082986070, 43 clinicians
Wa Pacs 2 PCGroup PAC ID 6901156538, 26 clinicians

Practice addresses (Care Compare)

10410 E 9TH Ave
Spokane Valley, WA 99206-3510
Phone (509) 926-3547

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Pacs 2 PC CurrentSince Jan 10, 2022 Accepting new patients
Washington Pac Services PC CurrentSince Jan 10, 2022 Accepting new patients
NV Pacs 2 LLC CurrentSince Feb 1, 2022 Accepting new patients
Northwest Post-Acute Care PC CurrentSince Feb 1, 2022 Accepting new patients
CS Pacs 3 Northwest, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

210 W Lacrosse Ave
Coeur D Alene, ID 83814
Phone (208) 664-2185

1125 N Division Ave
Sandpoint, ID 83864
Phone (208) 265-9299

3150 N Tenaya Way
Ste 350
Las Vegas, NV 89128
Phone (702) 243-6400

8025 Amigo St
Las Vegas, NV 89123
Phone (702) 251-6777

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422

1812 N Wall St
Spokane, WA 99205
Phone (509) 328-6030

3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000

10410 E 9th Ave
Spokane Valley, WA 99206
Phone (509) 321-9050

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

414 S University Rd
Spokane Valley, WA 99206
Phone (509) 924-4650

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1770955270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 HERITAGE BRIDGE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112670",
            "telephone_number": "702-328-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 HERITAGE BRIDGE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112670",
            "telephone_number": "702-328-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER-JOHNSON",
        "first_name": "LESLIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "APRN002142",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "APRN002142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.