MARISA JOHNSON (NPI# 1083615520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083615520 |
| Entity Type | Individual |
| Full Name | MARISA JOHNSON |
| Credential | MD |
| Practice Address |
1303 Line Ave Ste 400 Shreveport LA 71101-4628 |
| Practice Telephone | 3182212707 |
| Practice Fax Number | 3132212709 |
| Mailing Telephone | 3182212707 |
| Mailing Fax Number | 3132212709 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2017-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD.023908 | LA | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
023908 | LA | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
L6967 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 146986802 | 05 | |
| LA | 1487481 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837826 | Marisa Lee Johnson | Social Worker | 860 Wesley Cir Apt 206, Apopka, FL 32703-8673 | 2020-06-29 |
| 1699011767 | Marisa Protasel Johnson | Registered Nurse | 17618 128th Ave Se, Renton, WA 98058-6709 | 2012-12-18 |
| 1336783950 | Marisa Johnson | Technician/Technologist | 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 | 2019-11-06 |
| 1023596996 | Marisa Johnson | Counselor | 713 Troy Schenectady Rd Ste 224, Latham, NY 12110-2490 | 2018-08-02 |
| 1154874774 | Marisa Johnson | Physical Therapist | 10000 W 75th St, Suite 250, Merriam, KS 66204-2209 | 2016-07-31 |
| 1063811206 | Marisa Johnson | Psychologist | 737 E Hudson St, Columbus, OH 43211-1034 | 2014-08-13 |
| Street Address |
1303 LINE AVE STE 400 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| 1629187422 | John Stephen Kilpatrick | Internal Medicine | 745 Olive St Ste 207, Shreveport, LA 71104-2250 | 2006-08-29 |
| 1831184407 | Marwan Kaskas | Internal Medicine | 2501 Greenwood Rd, Shreveport, LA 71103-3905 | 2005-09-20 |
| 1710972559 | Arnold E Barz | Internal Medicine | 1800 Buckner St, Suite C120, Shreveport, LA 71101-4440 | 2005-09-19 |
| 1447242680 | Henry Edward Wood Jr. | Internal Medicine | 745 Olive St, Ste 200, Shreveport, LA 71104-2246 | 2005-08-15 |
| 1194292516 | Southern Kidney Associates Pllc | Internal Medicine | 1815 E 70th St, Shreveport, LA 71105-5301 | 2018-10-24 |
| 1356713440 | Delta Nephrology LLC | Internal Medicine | 745 Olive St, Suite 200, Shreveport, LA 71104-2246 | 2015-10-28 |
| 1386013670 | John S Kilpatrick Md A Professional Medical Corporation | Internal Medicine | 745 Olive St Ste 207, Shreveport, LA 71104-2250 | 2015-09-17 |
| 1295123644 | Melissa L Lynn Md Apmc | Internal Medicine | 2751 Albert L Bicknell Dr, Suite 3c, Shreveport, LA 71103-3920 | 2015-01-07 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on MARISA JOHNSON.
| 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.