Individual provider Active NPI

Reginald Johnson

  • Family Nurse Practitioner
  • Carlsbad, NM
National Provider Identifier
1902254477
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-02926 Issued in NM
Practice address
2409 W Pierce St
Suite a
Carlsbad, NM 88220-3513
Phone
(575) 887-8925
Fax
(575) 887-8935
NPI assigned
May 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-02926 NM Primary

Addresses

Primary practice location

2409 W Pierce St
Suite a
Carlsbad, NM 88220-3513

Mailing address

2409 W Pierce St
Suite a
Carlsbad, NM 88220-3513
Phone (575) 887-8925

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfp@artesiageneral.hin.us Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160719000894 NM Practitioner - Nurse Practitioner 9335432087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Artesia General HospitalGroup PAC ID 9537070586, 44 clinicians

Practice addresses (Care Compare)

702 N 13TH St
Artesia, NM 88210-1166
Phone (575) 748-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-02926NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Artesia General Hospital Family CurrentSince Jun 10, 2018 Accepting new patients
Artesia General Hospital CurrentSince Jun 10, 2018 Accepting new patients
Southwestern Regional Medical Center Family Past Accepting new patients
Artesia General Hospital Past Accepting new patients

Locations

612 N 13th St
Ste G
Artesia, NM 88210
Phone (505) 736-8262

702 N 13th St
Artesia, NM 88210
Phone (505) 748-3333

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/artesia-6a02e1ef

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1902254477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 W PIERCE ST",
            "address_2": "SUITE A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203513",
            "telephone_number": "575-887-8925",
            "fax_number": "575-887-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 W PIERCE ST",
            "address_2": "SUITE A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203513",
            "telephone_number": "575-887-8925",
            "fax_number": "575-887-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REGINALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfp@artesiageneral.hin.us",
            "affiliation": "N",
            "endpointDescription": "EHR Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "702 N 13th St",
            "city": "Artesia",
            "state": "NM",
            "country_code": "US",
            "postal_code": "882101166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.