Organization Active NPI

Windell Johnson, P. a.

  • Family Nurse Practitioner
  • White Hall, AR
National Provider Identifier
1881204758
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WINDELL JOHNSON, P. A.
Practice address
7500 Dollarway Rd Ste 301
White Hall, AR 71602-3084
Phone
(512) 201-6766
NPI assigned
Aug 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Habib Khan
Title
Manager
Phone
(512) 201-6766

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

7500 Dollarway Rd Ste 301
White Hall, AR 71602-3084

Mailing address

7604 Toltec Dr
North Little Rock, AR 72116-4586
Phone (512) 201-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220509000107 AR Part B Supplier - Clinic/Group Practice 6507243870 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, AR

National Provider Directory

National Provider Directory

Locations

1401 S State St
Ste C
Pine Bluff, AR 71601
Phone (501) 534-5523

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1881204758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 TOLTEC DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721164586",
            "telephone_number": "512-201-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 DOLLARWAY RD STE 301",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716023084",
            "telephone_number": "512-201-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDELL JOHNSON, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HABIB",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-201-6766"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.