Individual provider Active NPI

Elaina Sue Johnson, FNP

  • Family Medicine Physician
  • Cypress, TX
National Provider Identifier
1962072751
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1045861 Issued in TX
Practice address
10750 Barker Cypress Rd Ste 103
Cypress, TX 77433-2282
Phone
(832) 509-1842
NPI assigned
Jun 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1045861 TX Primary

Addresses

Primary practice location

10750 Barker Cypress Rd Ste 103
Cypress, TX 77433-2282

Mailing address

19323 Laguna Woods Dr
Tomball, TX 77375-1826
Phone (832) 683-0358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240311003086 TX Practitioner - Nurse Practitioner 3971949116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19323 Laguna Woods Dr
Tomball, TX 77375-1826
Phone (832) 683-0358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1045861TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wound to Wellness CurrentSince Jan 23, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1962072751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19323 LAGUNA WOODS DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773751826",
            "telephone_number": "832-683-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 BARKER CYPRESS RD STE 103",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774332282",
            "telephone_number": "832-509-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELAINA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1045861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.