Luiz Juan, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-132461 Issued in AL

Practice address

2605 Gault Ave N Ste 200
Fort Payne, AL 35967-3700

Phone

(256) 996-9121

NPI assigned

Feb 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gadsden HB Medical Services LLCGroup PAC ID 4183078561, 58 clinicians

Fort Payne Urgent Care LLCGroup PAC ID 3476933219, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dekalb Regional Medical Center Hospital, Fort Payne, AL, CCN 010012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25908/brand/1/csg/1/fhir/r4
• Direct secure messaging: luiz.juan.1@25908.direct.athenahealth.com

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.

• Fort Payne Urgent Care, LLC

  • Family Nurse Practitioner
  • Fort Payne, AL
  • NPI 1346986015

  Acute Care

  Medicare reassignment Care Compare group NPD Authorized official
• Gadsden HB Medical Services LLC

  • Emergency Medicine Physician
  • Gadsden, AL
  • NPI 1750061610
  Medicare reassignment Care Compare group NPD
• App of Alabama Ed PLLC

  • Emergency Medicine Physician
  • Russellville, AL
  • NPI 1659646040
  Medicare reassignment NPD

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

• HH Health System - Dekalb, LLC

  • General Acute Care Hospital
  • Fort Payne, AL
  • NPI 1770344665
  Care Compare affiliation

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1912446337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOREST AVE NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672054",
            "telephone_number": "256-996-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 GAULT AVE N STE 200",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673700",
            "telephone_number": "256-996-9121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 Maryland Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277516",
            "country_code": "US",
            "telephone_number": "615-928-6275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Medical Center Dr SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683458",
            "country_code": "US",
            "telephone_number": "256-997-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 Goodyear Ave",
            "address_purpose": "LOCATION",
            "city": "Gadsden",
            "state": "AL",
            "postal_code": "359031100",
            "country_code": "US",
            "telephone_number": "256-491-4102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUAN",
        "first_name": "LUIZ",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-132461",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "AL",
            "license": "1-132461",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "AL",
            "license": "1-132461",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-132461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brilee Johnson
• Chloe Johnson, MSW
• Emily S Jones
• Marja Lee Jones, CRNP
• Ketrina Lynn Jordan, EDD
• K-VA-T Food Stores Inc
• Kelseys Pharmacy Inc
• Kelli Kidd, MS,CCC-SLP
• Kidemics, LLC
• Kilgore Express Pharmacy Inc

• Family Nurse Practitioner in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.