Individual provider Active NPI

Raegan Renee Johns, ARNP

  • Family Nurse Practitioner
  • Ottumwa, IA
National Provider Identifier
1912434044
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A132654 Issued in IA
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

Updated by the provider on Jul 21, 2022

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201202000594 IA Order and Referring Only - Nurse Practitioner 7618245192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A132654IAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.