Randall Silven Johnston II, A-GNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

202864 Issued in LA

Practice address

2890 Douglas Dr # 100
Bossier City, LA 71111-5806

Phone

(318) 742-6900

NPI assigned

Jul 21, 2022

Last updated

Sep 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winn Community Health Center, Inc.Group PAC ID 2567516545, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Winn Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winnfield, LA
  • NPI 1275769119
  Medicare reassignment Care Compare group NPD
• Louisiana Family Medicine Clinic 1

  • Clinic/Center
  • Jonesboro, LA
  • NPI 1548538200
  Medicare reassignment NPD
• Winn Community Health Center, Inc.

  dba Cypress Springs ESBC

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1447133459
  NPD
• Winn Community Health Center, Inc.

  dba South Grant Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Dry Prong, LA
  • NPI 1891559688
  NPD
• Winn Community Health Center, Inc.

  dba Lincoln Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1477090959

  Nurse Practitioner

  NPD (past)
• Winn Community Health Center, Inc.

  dba Ball Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Ball, LA
  • NPI 1679218341
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1891420931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 COATES BLUFF DR APT 1525",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042800",
            "telephone_number": "318-229-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 DOUGLAS DR # 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115806",
            "telephone_number": "318-742-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "RANDALL",
        "middle_name": "SILVEN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "202864",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "202864",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "LA",
            "license": "202864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE BOARD OF NURSING",
            "identifier": "202864",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD",
            "identifier": "AG05220099",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Johnson, SPECIALIST
• Morgan Dieterich Johnson
• Paula Marie Johnson, RPH
• Shelby Taylor Johnson
• Austin James Johnston, DPT
• Jonathan B. Turgeon a Professional Dental LLC (Elite Family Dentistry)
• Jonathon B Turgeon a Proffessional Dental Limited Liability Company
• Taneshia Jones-Walker
• Brandi Jones
• Hasim Jones

• Primary Care Nurse Practitioner in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Primary Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.

Verify at the official NPI Registry.