MR. JERRY L JOHNSON (NPI# 1487721858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487721858 |
| Entity Type | Individual |
| Full Name | MR. JERRY L JOHNSON |
| Credential | MD |
| Practice Address |
503 S John Redditt Dr Lufkin TX 75904-3120 |
| Mailing Address |
503 South John Redditt Lufkin TX 75904 |
| Practice Telephone | 9366321533 |
| Practice Fax Number | 9366321726 |
| Mailing Telephone | 9366321533 |
| Mailing Fax Number | 9366321726 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2016-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | J2117 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 099143202 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629454897 | Jerry Johnson | Pharmacist | 4004 Lake Adger Pkwy, Mill Spring, NC 28756-4800 | 2015-08-10 |
| 1730260829 | Jerry Lee Johnson | Chiropractor | 11914 N Pennsylvania Ave Ste B3, Oklahoma City, OK 73120-7831 | 2006-10-17 |
| 1780779140 | Jerry Allen Johnson | Physician Assistant | 1201 Sam Bass Road, Round Rock, TX 78681-4137 | 2006-10-03 |
| 1003907817 | Jerry Lee Johnson | Chiropractor | 4312 Mormon Coulee Rd, La Crosse, WI 54601-7908 | 2006-09-27 |
| 1346253499 | Jerry N Johnson | Chiropractor | 1502 E Belt Line Rd, Carrollton, TX 75006-6307 | 2006-08-13 |
| 1316975568 | Jerry Lee Johnson | Dentist | 1316 Mcmillan St, Worthington, MN 56187-1646 | 2006-06-28 |
| 1871584565 | Jerry Alan Johnson | Dentist | 2295 E Washington Blvd, Pasadena, CA 91104-1944 | 2005-11-02 |
| 1952305351 | Jerry H Johnson | Dentist | 1277 Highway 411, Vonore, TN 37885-2456 | 2005-06-13 |
| 1962057802 | Jerry Michael Johnson | Pharmacist | 311 S Avenue D, Burkburnett, TX 76354-3541 | 2019-08-07 |
| 1144704248 | Jerry Johnson | Case Manager/Care Coordinator | 6701 Highway 67, Benton, AR 72015-8909 | 2018-09-24 |
| Street Address |
503 S JOHN REDDITT DR |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019705 | Hailey Lorayne Johnson | Nurse Practitioner | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2020-06-26 |
| 1023576782 | Carlie Rae Merritt | Nurse Practitioner | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2019-03-12 |
| 1508291048 | Megan Kay Dickinson | Nurse Practitioner | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2013-09-03 |
| 1255681003 | Katherine Blythe Diggs | Nurse Practitioner | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2012-09-19 |
| 1316297161 | Karol B Brown | Clinical Nurse Specialist | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2012-09-19 |
| 1174824510 | Jerry L Johnson Md Pa | Obstetrics & Gynecology | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2010-11-16 |
| 1346420429 | Kaywin M Carter Md Facog & Associates | Obstetrics & Gynecology | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2007-11-06 |
| 1275652901 | Kaywin M. Carter, M.d. | Specialist | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2007-03-27 |
| 1295802668 | Kaywin Mahoney Carter | Obstetrics & Gynecology | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851349732 | Sheila L Hill | Obstetrics & Gynecology | 121 Gaslight Medical Pkwy, Ste 102, Lufkin, TX 75904-3147 | 2006-05-04 |
| 1124378328 | Whs Obgyn Pllc | Obstetrics & Gynecology | 121 Gaslight Medical Pkwy, Ste 102, Lufkin, TX 75904-3147 | 2012-09-14 |
| 1205198561 | Rachael Elizabeth Sullivan | Obstetrics & Gynecology | 1105 W Frank Ave, Suite 200, Lufkin, TX 75904-3303 | 2012-06-13 |
| 1174824510 | Jerry L Johnson Md Pa | Obstetrics & Gynecology | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2010-11-16 |
| 1770895120 | Michael L. Arnold, M.d., P.a. | Obstetrics & Gynecology | 401 Gaslight Blvd, Lufkin, TX 75904-3132 | 2010-07-13 |
| 1942484712 | East Texas Women's Clinic | Obstetrics & Gynecology | 401 Gaslight Blvd, Lufkin, TX 75904-3132 | 2007-12-28 |
| 1346420429 | Kaywin M Carter Md Facog & Associates | Obstetrics & Gynecology | 503 S John Redditt Dr, Lufkin, TX 75904-3120 | 2007-11-06 |
| 1952599037 | Carolyn Marie Moyers | Obstetrics & Gynecology | 1105 W Frank Ave, Suite 200, Lufkin, TX 75904-3303 | 2007-10-14 |
| 1093915142 | Cheryl Rene Suiter | Obstetrics & Gynecology | 402 Gaslight Blvd, Lufkin, TX 75904-3123 | 2007-07-18 |
| 1144427261 | Dixie Ann Mcclendon-coker | Obstetrics & Gynecology | 1105 W Frank Ave, Suite 110, Lufkin, TX 75904-3303 | 2007-07-02 |
| Find all providers in LUFKIN | ||||
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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.