KENYUA N JOHNSON (FNP-BC) – Family Nurse Practitioner, NPI 1669815478
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,440 NURSE PRACTITIONER in TX
Provider Addresses for KENYUA N JOHNSON (FNP-BC)
1485 George Dieter Dr Ste 107
El Paso, TX 799367685
Phone: (915) 790-5700
Type: Location
2801 Missouri Ave Ste 22
Las Cruces, NM 880115062
Phone: (575) 636-2550
Type: Location
5312 Rio Bravo Dr Ste 10
Santa Teresa, NM 880089210
Phone: (575) 915-1338
Fax: (575) 915-1819
Type: Location
1415 VICTORIA ST
APT 205
HONOLULU, HI 968223685
Phone:
Type: Mailing
12193 DOS RIOS DR APT 205
EL PASO, TX 799360260
Phone:
Type: Mailing
4642 N MESA ST
EL PASO, TX 799126104
Phone: (915) 200-2650
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $512.
Total Amount is formed as General ($512) + Research ($0) + Ownership ($0) = $512.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($184).
Total Amount
$512
General + Research + Ownership
Payments
18
Total payment records
General Amount
$512
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-03
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170918001058 | I | Nurse Practitioner | TX | TBD |
| I20230908002906 | I | Nurse Practitioner | NM | TBD |
| I20250121003591 | I | Nurse Practitioner | IL | TBD |
| I20250603004033 | I | Nurse Practitioner | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79936)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Certified Clinical Nurse Specialist (Cns) | TX | |
| Internal Medicine | NM | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | NM | |
| Clinical Social Worker | NM |
Reviews
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