Active NPI
Riley Johnson, FNP
- Family Nurse Practitioner
- Bend, OR
National Provider Identifier
1821954454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10008876
- Practice address
- 56451 Celestial Dr
Bend, OR 97707-2007 - Phone
- (916) 607-0740
- NPI assigned
- Dec 29, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10008876 | OR | Primary |
Addresses
Primary practice location
56451 Celestial Dr
Bend, OR 97707-2007
Mailing address
56451 Celestial Dr
Bend, OR 97707-2007
Phone (916) 607-0740
Other practice location 1
1555 S Highway 97
Redmond, OR 97756-9652
Phone (541) 204-4304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1555 S Hwy 97
Suite 101
Redmond, OR 97756-9652
Phone (541) 640-7625
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10008876 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icco, LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1766966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1821954454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56451 CELESTIAL DR",
"city": "BEND",
"state": "OR",
"postal_code": "977072007",
"telephone_number": "916-607-0740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56451 CELESTIAL DR",
"city": "BEND",
"state": "OR",
"postal_code": "977072007",
"telephone_number": "916-607-0740"
}
],
"practiceLocations": [
{
"address_1": "1555 S Highway 97",
"address_purpose": "LOCATION",
"city": "Redmond",
"state": "OR",
"postal_code": "977569652",
"country_code": "US",
"telephone_number": "541-204-4304",
"fax_number": "541-640-7419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "RILEY",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-29",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "10008876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.