Lara K Johnson (NPI# 1174881775, PAC ID# 6507138666) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1174881775 |
PAC ID by PECOS | 6507138666 |
Professional Enrollment ID | I20170824000600 |
Full Name | Lara K Johnson |
Organization Legal Name | TITUSVILLE AREA HEALTH SERVICES, INC. |
Address |
111 Bridge St Tionesta PA 16353-9737 |
Phone Number | 8147553633 |
Gender | F |
Graduation Year | 2017 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 3173505997 |
Number of Group Practice Members | 6 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
391314 | TITUSVILLE HOSPITAL |
Address | Phone | Organization |
---|---|---|
116 Central Ave, Oil City, PA 16301-2736 | 8146760431 | TITUSVILLE AREA HOSPITAL |
111 Bridge St, Tionesta, PA 16353-9737 | 8147553633 | TITUSVILLE AREA HEALTH SERVICES, INC. |
335 W Oak St, Jay D Stevens M.d., Titusville, PA 16354-1416 | 8148278962 | TITUSVILLE AREA HEALTH SERVICES, INC. |
Organization Legal Name | TITUSVILLE AREA HEALTH SERVICES, INC. |
Physicians | 5 |
Name | Specialty | Organization | Address |
---|---|---|---|
James B Wilkens Jr. | Internal Medicine | Titusville Area Health Services, Inc. | 406 W Oak St, Titusville Surgical Associates, Titusville, PA 16354-1404 |
Dwain M Rogers | General Surgery | Titusville Area Health Services, Inc. | 406 W Oak St, Titusville, PA 16354-1404 |
Michael L Dvorkin | Orthopedic Surgery | Titusville Area Health Services, Inc. | 406 W Oak St, Titusville Surgical Associates, Titusville, PA 16354-1404 |
Constantine M Dy | Family Medicine | Titusville Area Health Services, Inc. | 111 Bridge St, Tionesta, PA 16353-9737 |
Street Address |
111 BRIDGE ST |
City | TIONESTA |
State | PA |
Zip | 16353-9737 |
Name | Specialty | Organization | Address |
---|---|---|---|
Constantine M Dy | Family Medicine | Titusville Area Health Services, Inc. | 111 Bridge St, Tionesta, PA 16353-9737 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kerry E Bussoletti | Physician Assistant | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Deanann Farris | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
John P. John | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Kathleen T Patterson | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Karen Ashbaugh | Clinical Social Worker | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
John F Simora | Psychiatry | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Eric C Decker | Physician Assistant | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Richard S Barton | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
Kelly C Allen | Nurse Practitioner | Childrens Center for Treatment and Education | 613 Elm St, Tionesta, PA 16353-9751 |
City | TIONESTA |
Zip Code | 16353 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | TIONESTA + PHYSICIAN ASSISTANT |
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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.