MR. JACKIE RAY JOHNSON (NPI# 1053320218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053320218 |
| Entity Type | Individual |
| Full Name | MR. JACKIE RAY JOHNSON |
| Credential | CRNA |
| Practice Address |
8200 Walnut Hill Ln Dallas TX 75231-4426 |
| Mailing Address |
3008 Shilling Rd Texarkana TX 75503-5423 |
| Practice Telephone | 2143457175 |
| Mailing Telephone | 9037922173 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2009-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 510698 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 89723U | 01 |
| TX | 002509002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871130112 | Jackie Glen Johnson | Case Management | 434 Ashlawn Dr, Midlothian, TX 76065-5612 | 2019-12-05 |
| 1770745457 | Jackie Eugene Johnson Sr. | Counselor | 1020 Sw Taylor St Ste 650, Portland, OR 97205-2506 | 2008-06-25 |
| 1982185021 | Jackie Johnson | Registered Nurse | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2018-08-27 |
| 1982114344 | Jackie Jerome Johnson Sr. | Counselor | 1715 26th St, Lubbock, TX 79411-1524 | 2017-10-11 |
| 1861940108 | Jackie Johnson | Massage Therapist | 12923 Nw Cornell Rd Ste 201, Portland, OR 97229-5834 | 2016-09-15 |
| 1740692318 | Jackie Johnson | Behavioral Analyst | 2605 Rainbow Glow St, North Las Vegas, NV 89030-3709 | 2014-05-29 |
| 1407166119 | Jackie Johnson | Student in an Organized Health Care Education/Training Program | 111 South St., Somerville, MA 02143 | 2010-10-15 |
| 1740516251 | Jackie Ann Johnson | Licensed Practical Nurse | 627 Smithview Dr, Maryville, TN 37803-6100 | 2009-10-19 |
| 1679707541 | Jackie H Johnson Jr. | Ophthalmology | 216 Corder Rd, Warner Robins, GA 31088 | 2009-05-07 |
| Street Address |
8200 WALNUT HILL LN |
| City | DALLAS |
| State | TX |
| Zip Code | 75231-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801630 | Joyzelle Herod Mccreary | Psychologist | 8200 Walnut Hill Ln, Department of Psychiatry, Dallas, TX 75231-4426 | 2005-09-20 |
| 1831702091 | Leigh Kraft | Nurse Practitioner | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-08-27 |
| 1518583657 | Rebecca Ann Brubaker | Nurse Practitioner | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-06-24 |
| 1609490903 | Utsuk Bhattarai | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231 | 2020-06-02 |
| 1801416482 | Hsiang Chih Tseng | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-23 |
| 1013536549 | Pouria Hosseini | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-14 |
| 1154940732 | William Taylor Farrington | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-13 |
| 1003435801 | David Byron Duff | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-11 |
| 1083243703 | Sunny Narula | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-04 |
| 1376172320 | William Cameron Ford | Student in an Organized Health Care Education/Training Program | 8200 Walnut Hill Ln, Dallas, TX 75231-4402 | 2020-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987022 | Specialists In Geriatric and Palliative Care Medicine Pllc | Clinic/Center | 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 | 2020-09-21 |
| 1013546118 | The Legacy Midtown Park, Inc | Skilled Nursing Facility | 8280 Manderville Lane, Dallas, TX 75231 | 2020-04-02 |
| 1003383373 | Northeast Dallas Dentistry, PC | Dentist | 6401 East Northwest Highway, Suite 100, Dallas, TX 75231 | 2018-10-25 |
| 1518442565 | Daniel Max & Marc Andrea LLC | Optometrist | 6471 E Northwest Hwy, Dallas, TX 75231 | 2018-09-26 |
| 1760964100 | Amber Nicole Caruthers | Nurse Practitioner | 8060 Park Lane, Dallas, TX 75231 | 2018-09-01 |
| 1376024893 | Brittany Leigh Stedman | Physical Therapist | 8130 Meadow Rd, Dallas, TX 75231 | 2018-08-23 |
| 1700367224 | Tia Cornelius | Occupational Therapy Assistant | 8130 Meadow Rd., Dallas, TX 75231 | 2018-08-23 |
| 1538653753 | Manju R. Goyal M.d. Psychiatry Pllc | Psychiatry & Neurology | 5477 Glen Lakes Dr Ste 210, Dallas, TX 75231 | 2018-06-20 |
| 1497246813 | Stacy Jo Thomas | Counselor | 10260 N Central Expy Ste 280, Dallas, TX 75231 | 2018-05-21 |
| 1235626615 | Texas Health Presbyterian Hospital Dallas | Durable Medical Equipment & Medical Supplies | 8160 Walnut Hill Lane, First Floor, Dallas, TX 75231 | 2018-04-20 |
| Find all providers in zip 75231 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063056703 | Devco Anesthesia Services, Pllc | Nurse Anesthetist, Certified Registered | 7147 Royal Ln, Dallas, TX 75230-3607 | 2019-11-06 |
| 1861044224 | Texas Joint Pain Management, Pllc | Nurse Anesthetist, Certified Registered | 8611 Hillcrest Rd Ste 245d, Dallas, TX 75225-4203 | 2019-07-15 |
| 1851890636 | Old Town Endoscopy Center LLC | Nurse Anesthetist, Certified Registered | 5500 Greenville Avenue Suite 1100, Dallas, TX 75206 | 2018-02-07 |
| 1114438991 | Donald R Missel | Nurse Anesthetist, Certified Registered | 6606 Lbj Freeway, Suite 200, Dallas, TX 75240 | 2017-10-19 |
| 1225554165 | Southwest Joint Pain Management, LLC | Nurse Anesthetist, Certified Registered | 8611 Hillcrest Rd, Suite 245d, Dallas, TX 75225 | 2017-08-22 |
| 1689104796 | Jaade Anesthesia Management LLC. | Nurse Anesthetist, Certified Registered | 17980 Dallas Pkwy Ste 100, Dallas, TX 75287-6817 | 2017-06-13 |
| 1144755224 | Rpr Et Associates LLC | Nurse Anesthetist, Certified Registered | 11201 Leachman Cir, Dallas, TX 75229-4349 | 2017-04-26 |
| 1316393218 | Miranda Limmer | Nurse Anesthetist, Certified Registered | 1623 Main St, Apt. 702, Dallas, TX 75201-4740 | 2016-05-10 |
| 1942661988 | Hanan Genet Johnson | Nurse Anesthetist, Certified Registered | 5200 Harry Hinesblvd, Dallas, TX 75235 | 2016-03-18 |
| 1891166039 | Td Anesthesia Services | Nurse Anesthetist, Certified Registered | 3728 Shady Hill Dr, Dallas, TX 75229-2711 | 2015-10-14 |
| Find all providers in DALLAS | ||||
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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.