Individual provider Active NPI

Janna S Nichols, NP

  • Nurse Practitioner
  • Bossier City, LA
National Provider Identifier
1780918490
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200338 Issued in LA
Practice address
5400 E. Texas St
Bossier City, LA 71111
Phone
(318) 675-1313
Fax
(888) 965-0619
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 531115 TX
Nurse Practitioner 363L00000X 200338 LA Primary

Addresses

Primary practice location

5400 E. Texas St
Bossier City, LA 71111

Mailing address

5400 E. Texas St
Bossier City, LA 71111
Phone (318) 675-1313

Other identifiers 1

IdentifierTypeStateIssuer
200338MedicaidLA

Other names 1

  • Ms. Janna S Knox Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 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
I20110301000182 TX Practitioner - Nurse Practitioner 8527249275 Reassigns benefits to 3 organizations
I20200716001801 LA Practitioner - Nurse Practitioner 8527249275 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200338LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince May 1, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince May 1, 2021 Accepting new patients
Synergy International Healthcare Services, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince May 1, 2021 Accepting new patients
Total MD Physicians Group, PLLC CurrentSince Apr 1, 2023 Accepting new patients
Neil Halim Fairfield Family Clinic CurrentSince Sep 15, 2022 Accepting new patients
House Call Doctors Texas PLLC Nurse Practitioner Past Accepting new patients

Locations

5400 E Texas St
Bossier City, LA 71111
Phone (318) 464-7504

1860 Fairfield Ave
Shreveport, LA 71101
Phone (318) 229-7514

4301 W William Cannon Dr
#300
Austin, TX 78749
Phone (512) 222-8868

823 Congress Ave
Ste 125
Austin, TX 78701
Phone (512) 229-1533

8300 N Lamar Blvd
Ste 200A
Austin, TX 78753
Phone (512) 575-9555

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

5401 FM 1626
Ste 150
Kyle, TX 78640
Phone (512) 200-2834

603 Louis Henna Blvd
Ste B140
Round Rock, TX 78664
Phone (512) 200-2269

Organizations & group practices 8

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1780918490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 E. TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-675-1313",
            "fax_number": "888-965-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 E. TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-675-1313",
            "fax_number": "888-965-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JANNA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "531115",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "200338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200338",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANNA",
            "last_name": "KNOX",
            "middle_name": "S",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.