Brandon Warren Johnson (NPI# 1225519291, PAC ID# 6406190388) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1225519291 |
| PAC ID by PECOS | 6406190388 |
| Professional Enrollment ID | I20181204000834 |
| Full Name | Brandon Warren Johnson |
| Organization Legal Name | KINGSFORD PHYSICIAN SERVICES LLC |
| Address |
2400 Lee Hwy N Pulaski VA 24301-2326 |
| Phone Number | 5409948100 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0840541017 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490116 | LEWISGALE HOSPITAL PULASKI |
| Address | Phone | Organization |
|---|---|---|
| 2400 Lee Hwy N, Pulaski, VA 24301-2326 | 5409948100 | KINGSFORD PHYSICIAN SERVICES LLC |
| Organization Legal Name | KINGSFORD PHYSICIAN SERVICES LLC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony G Patriarco | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Kenneth R Pendergrast | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Angela P Blackman | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Aja S Buhler | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Melanie M Hudgins | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Saddam Ehsan Zaidi | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Feras J Ghosheh | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Christy Fagg | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| David Daniel Bradley | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Erica A Waddle | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Street Address |
2400 LEE HWY N |
| City | PULASKI |
| State | VA |
| Zip | 24301-2326 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph D Cacioppo | Emergency Medicine | Kingsford Emergency Group, LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Anthony G Patriarco | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Kenneth R Pendergrast | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Bita Mansouri | Emergency Medicine | Kingsford Emergency Group, LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Benjamin S Davidson | Emergency Medicine | Kingsford Emergency Group, LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Angela P Blackman | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Alexander Fernandez | Certified Registered Nurse Anesthetist (crna) | Pulaski Community Hospital Inc | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Aja S Buhler | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Melanie M Hudgins | Nurse Practitioner | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Saddam Ehsan Zaidi | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea W Rupe | Nurse Practitioner | 101 1st Nwst, Suite 2, Pulaski, VA 24301 | |
| Karanita M Ojomo | Radiation Oncology | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2400 Lee N Hwy, Pulaski, VA 24301-2326 |
| Feras J Ghosheh | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| J Frederick Hyduke | Anesthesiology | 2400 Lee Hwy N, Pulaski, VA 24301-2326 | |
| Owen W Roberts | Hematology/oncology | Lewis Gale Physicians LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Christy Fagg | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| David Daniel Bradley | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Erica A Waddle | Internal Medicine | Kingsford Physician Services LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Jane S Weiseman | Emergency Medicine | Kingsford Emergency Group, LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Scott A Wright | Internal Medicine | Kingsford Emergency Group, LLC | 2400 Lee Hwy N, Pulaski, VA 24301-2326 |
| Find all physicians in zip 24301 | |||
| City | PULASKI |
| Zip Code | 24301 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PULASKI + NURSE PRACTITIONER |
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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.