THERRYLL L JOHNSON (NPI# 1093816381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093816381 |
| Entity Type | Individual |
| Full Name | THERRYLL L JOHNSON |
| Credential | MD |
| Practice Address |
1990 Industrial Boulevard Houma LA 70363-7055 |
| Practice Telephone | 9858689300 |
| Practice Fax Number | 9858731766 |
| Mailing Telephone | 9858689300 |
| Mailing Fax Number | 9858510053 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 015157 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1328863 | 05 |
| Street Address |
1990 INDUSTRIAL BOULEVARD |
| City | HOUMA |
| State | LA |
| Zip Code | 70363-7055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548245814 | Scott F Diedrich | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2005-12-09 |
| 1629150925 | Cheri A Hemelt | Obstetrics & Gynecology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-10-19 |
| 1346322641 | Claude Simon | Radiology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-10-19 |
| 1780766089 | Brigitte H Demoss | Pathology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-10-19 |
| 1184721169 | Paul J Cummins | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1992802987 | Christopher Powell | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1285731455 | Michael Berthiaume | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1750316931 | Abram D Tipton Iv | Ophthalmology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-07-12 |
| 1972538155 | John M Falgout | Nurse Practitioner | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-07-12 |
| 1780616953 | Randall Dwight Bass | Pathology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286991 | Nadish Ravindran | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Internal Medicine Program, Chabert Medical Center, Houma, LA 70363 | 2020-05-08 |
| 1912527185 | Gurjit Singh Brar | Student in an Organized Health Care Education/Training Program | Chabert Medical Center 1978 Industrial Blvd, Internal Medicine Residency Program, Houma, LA 70363 | 2020-04-17 |
| 1912568718 | Blake P Pitre | Pharmacist | 13087 West Main St, Larose, LA 70363 | 2019-06-24 |
| 1528623212 | Navkiran Singh Jagdev | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2019-05-08 |
| 1376107367 | Sheahahn Vikash Soundranayagam | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program Chabert Medical, Center, 1978 Industrial Blvd, Hourna, LA 70363 | 2019-04-25 |
| 1962991034 | Naveen Silva | Student in an Organized Health Care Education/Training Program | 1976 Industrial Blvd, Internal Medicine Residency Program Chabert Medical Cen, Houma, LA 70363 | 2018-05-04 |
| 1841647526 | Ammad Asad Syed | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd., Internal Medicine Residency Program, Chabert Medical Ce, Houma, LA 70363 | 2016-05-23 |
| 1538514450 | Khizran Rizvi | Internal Medicine | 1978 Industrial Blvd. Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2016-04-28 |
| 1649656836 | David Price | Pharmacist | 9303 East Parke Avenue, Houma, LA 70363 | 2015-08-11 |
| 1346638053 | Donna Marie Neville | Case Manager/Care Coordinator | 137 New Orleans Blvd, Houma, LA 70363 | 2015-01-05 |
| Find all providers in zip 70363 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265756266 | Watkins Family Medicine LLC | Family Medicine | 928 School St, Houma, LA 70360-4628 | 2010-03-19 |
| 1023271756 | Barrett Day | Family Medicine | 6896 W Park Ave, Houma, LA 70364-2664 | 2008-07-02 |
| 1902955073 | Michael L Watkins | Family Medicine | 606 Liberty St, Houma, LA 70360-4622 | 2007-01-09 |
| 1851484307 | Lisa Breaux Black | Family Medicine | 895 Verret St, Houma, LA 70360-4635 | 2006-10-02 |
| 1629004601 | William H. St. Martin | Family Medicine | 818 Verret Street, Houma, LA 70360 | 2006-06-23 |
| 1437118890 | Brian J Matherne | Family Medicine | 291 Liberty St, Houma, LA 70360-4423 | 2006-03-22 |
| 1497219539 | Kelsey Morris | Family Medicine | 1007 Belanger St, Houma, LA 70360-4411 | 2019-01-23 |
| 1891107900 | Nathan Sutton | Family Medicine | 8166 Main St, Houma, LA 70360-3404 | 2014-05-22 |
| 1871849620 | Brittany Wyger | Family Medicine | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2012-07-31 |
| 1740546381 | James Matthew Watkins Jr. | Family Medicine | 502 Barrow St, Houma, LA 70360-4606 | 2012-04-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.