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NPI 1316610017ActiveOrganization· Nurse Practitioner, Family· Port Arthur, TX
Nurse Practitioner, Family in Port Arthur, Texas, registered in NPPES in July 2021. The authorized official on file is Connie D. Johnson-Wiltz, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1316610017 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 28, 2021 |
| Last updated in NPPES | Oct 3, 2023 |
| Certified by provider | Oct 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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