Active NPI
Raegan Renee Johns, ARNP
- Family Nurse Practitioner
- Ottumwa, IA
National Provider Identifier
1912434044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A132654
- Practice address
- 201 S Market St
Ottumwa, IA 52501-2924 - Phone
- (641) 683-5773
- Fax
- (641) 226-5759
- NPI assigned
- May 19, 2017
- 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 | A132654 | IA | Primary |
Addresses
Primary practice location
201 S Market St
Ottumwa, IA 52501-2924
Mailing address
PO Box 458
Ottumwa, IA 52501-0458
Phone (641) 684-6896
Other practice location 1
1229 C Ave E
Oskaloosa, IA 52577-4246
Phone (641) 672-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201202000594 | IA | Order and Referring Only - Nurse Practitioner | 7618245192 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A132654 | IA | MD | Family Nurse Practitioner |
Interoperability endpoints
- rjohns620561@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1912434044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 458",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525010458",
"telephone_number": "641-684-6896",
"fax_number": "641-226-5759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S MARKET ST",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525012924",
"telephone_number": "641-683-5773",
"fax_number": "641-226-5759"
}
],
"practiceLocations": [
{
"address_1": "1229 C Ave E",
"address_purpose": "LOCATION",
"city": "Oskaloosa",
"state": "IA",
"postal_code": "525774246",
"country_code": "US",
"telephone_number": "641-672-3100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNS",
"first_name": "RAEGAN",
"middle_name": "RENEE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-19",
"last_updated": "2022-07-21",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A132654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.