Michael Ernest Johnson (NPI# 1154524742, PAC ID# 0042378630) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1154524742 |
| PAC ID by PECOS | 0042378630 |
| Professional Enrollment ID | I20081027000327 |
| Full Name | Michael Ernest Johnson |
| Organization Legal Name | SOUTHEASTERN PHYSICIAN SERVICES PC |
| Address |
1441 Charic Dr Ballwin MO 63021-2001 |
| Phone Number | 6363942522 |
| Gender | M |
| Medical School | MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 0042307852 |
| Number of Group Practice Members | 242 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260191 | BARNES-JEWISH ST PETERS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1441 Charic Dr, Ballwin, MO 63021-2001 | 6363942522 | SOUTHEASTERN PHYSICIAN SERVICES PC |
| 894 Leland Ave, Saint Louis, MO 63130-3239 | 3147264767 | SOUTHEASTERN PHYSICIAN SERVICES PC |
| 10 Hospital Dr, Saint Peters, MO 63376-1659 | 8005019855 | SOUTHEASTERN PHYSICIAN SERVICES PC |
| Organization Legal Name | SOUTHEASTERN PHYSICIAN SERVICES PC |
| Physicians | 263 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Faisal A Soliman | Internal Medicine | Southeastern Physician Services PC | 1995 Hwy 51 S, Covington, TN 38019-3635 |
| Tia Camille Joyce | Nurse Practitioner | Southeastern Physician Services PC | 157 Ross Carter Blvd, Duffield, VA 24244-5116 |
| Patrick C Finney | Internal Medicine | Southeastern Physician Services PC | 2501 Kentucky Ave, Paducah, KY 42003-3813 |
| Carol Ann Berger | Nurse Practitioner | Southeastern Physician Services PC | 300 1st Capitol Dr, Saint Charles, MO 63301-2844 |
| William T Rawlinson | Internal Medicine | Southeastern Physician Services PC | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 |
| Mark D Nowell | Emergency Medicine | Southeastern Physician Services PC | 723 Burkesville Rd, Albany, KY 42602-1654 |
| Lavada Smith | Nurse Practitioner | Southeastern Physician Services PC | 894 Leland Ave, Saint Louis, MO 63130-3239 |
| Kevin L Flowers | Family Medicine | Southeastern Physician Services PC | 1100 Brookhaven Rd, Franklin, KY 42134-2746 |
| Peter J Anderson | Internal Medicine | Southeastern Physician Services PC | 989 Medical Park Dr, Maysville, KY 41056-8750 |
| Hunter Stidham | Physician Assistant | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Street Address |
1441 CHARIC DR |
| City | BALLWIN |
| State | MO |
| Zip | 63021-2001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cindy Haller | Clinical Social Worker | Deer Oaks Mental Health Associates PC | 1441 Charic Dr, Wildwood, MO 63021-2001 |
| Uyen Phan | Family Medicine | Southeastern Physician Services PC | 1441 Charic Dr, Ballwin, MO 63021-2001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carmen F Castellano | Optometry | The Koetting Associates Inc | 113 Old State Rd, Suite 101, Ellisville, MO 63021-2042 |
| Kaori A Sakurai | Internal Medicine | Generation Clinical Partners LLC | 1 Meramec Bluffs Dr, Ballwin, MO 63021-3309 |
| Jenna A Sanders | Nurse Practitioner | Tri-county Family Practice, LLC | 1 Meramec Bluffs Dr, Ballwin, MO 63021-3309 |
| Mohammad A Zaman | Internal Medicine | 703 Hesemann Ridge Ct, Wildwood, MO 63021-3602 | |
| Lisa A Chabot | Optometry | Chabot Community Eye Care PC | 312 Solley Dr, Ballwin, MO 63021-5248 |
| Duane J Marquart | Chiropractic | 201 Enchanted Pkwy, Ballwin, MO 63021-5493 | |
| Patrick H Fox | Chiropractic | 134 Enchanted Pkwy, Suite 104, Manchester, MO 63021-5495 | |
| Dana E Alter | Chiropractic | 134 Enchanted Pkwy, Suite 104, Manchester, MO 63021-5495 | |
| Beth C James | Physical Therapy | Prorehab PC | 13537 Barrett Pkwy Dr, Suite 105, Ballwin, MO 63021-5896 |
| Lisa R Schwarztrauber | Occupational Therapy | Prorehab PC | 13537 Barrett Pkwy Dr, Suite 105, Ballwin, MO 63021-5896 |
| Find all physicians in zip 63021 | |||
| City | BALLWIN |
| Zip Code | 63021 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | BALLWIN + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.