LARRY DEAN JOHNSON (NPI# 1205970365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205970365 |
| Entity Type | Individual |
| Full Name | LARRY DEAN JOHNSON |
| Credential | PA |
| Practice Address |
620 North Main Harrison AR 72601-2911 |
| Mailing Address |
Po Box 650 Branson MO 65615 |
| Practice Telephone | 8703652000 |
| Mailing Telephone | 4173357218 |
| Mailing Fax Number | 4173357588 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2017-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-263 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2004021594 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR BLUE CROSS | 84690 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367032 | Larry R Johnson Jr. | Registered Nurse | 5011 State Rd, Fort Gratiot, MI 48059-2909 | 2018-12-16 |
| 1093103491 | Larry Johnson Sr. | Private Vehicle | 600 Lake Air Dr, Suite 3a, Waco, TX 76710-5887 | 2015-01-07 |
| 1578981262 | Larry Johnson | Pharmacist | 18928 Auberry Rd, Clovis, CA 93619-9641 | 2014-03-31 |
| 1841588316 | Larry Brian Johnson | Pharmacist | 37435 Main St, Burney, CA 96013-4372 | 2011-07-18 |
| 1396983888 | Larry Wayne Johnson | Specialist | 9570 Ridgehaven Ct, Suite C, San Diego, CA 92123-1667 | 2009-01-22 |
| 1669448155 | Larry Dean Johnson | Chiropractor | 413 Ne Van Loon Ln, #126, Cape Coral, FL 33909-2525 | 2006-02-24 |
| 1932183043 | Larry Wayne Johnson | Family Medicine | 1015 Garden Lake Pkwy, Toledo, OH 43614-2779 | 2005-12-01 |
| 1275514911 | Larry Hugh Johnson | Family Medicine | 7643 Oak Park Pl Nw, Bremerton, WA 98311-9175 | 2005-11-09 |
| 1487203477 | Larry Darnell Johnson | Social Worker | 1030 5th Ave Se Ste 3000, Cedar Rapids, IA 52403-2416 | 2019-09-11 |
| 1902370281 | Larry D Johnson | Counselor | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2019-01-19 |
| Street Address |
620 NORTH MAIN |
| City | HARRISON |
| State | AR |
| Zip Code | 72601-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801874698 | Todd F Baker | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2006-01-03 |
| 1194095448 | Jesse A Larbey | Physician Assistant | 620 North Main, Harrison, AR 72601-2911 | 2012-01-04 |
| 1962693218 | Luana D Booth | Nurse Anesthetist, Certified Registered | 620 North Main, Harrison, AR 72601-2911 | 2007-08-01 |
| 1417161795 | Eli Nathanael Denney | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2007-05-09 |
| 1063585966 | Joseph Lee Thomas | Nurse Practitioner | 620 North Main, Harrison, AR 72601-2926 | 2006-11-16 |
| 1376623744 | Catherine J Langston | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2006-10-17 |
| 1700820602 | Raymond Kent Griffith | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2006-06-15 |
| 1265474472 | Jacob Aaron Roberts | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2006-06-12 |
| 1295791556 | Craig B Olson | Radiology | 620 North Main, Harrison, AR 72601-2911 | 2006-04-25 |
| 1235195785 | Timothy D Costello | Emergency Medicine | 620 North Main, Harrison, AR 72601-2926 | 2006-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280364 | Linda Marie Balcerak | Physical Therapy Assistant | 400 Hwy 43 East, Harrison, AR 72601 | 2019-05-14 |
| 1750847315 | Boston Mountain Rural Health Center Inc. | Clinic/Center | 1002 North Spring St., Harrison, AR 72601 | 2019-02-19 |
| 1154808236 | Carrie Lynn Miller | Midwife | 5977 Sulphur. Mt. Rd, Harrison, AR 72601 | 2018-07-23 |
| 1255833778 | Julie Foster, Speech Language Pathologist, Inc. | Speech-Language Pathologist | 1898 Foley Rd, Harrison, AR 72601 | 2018-02-28 |
| 1386163582 | Reagan Brittany Kenney | Case Manager/Care Coordinator | 4537 Meadow Wood Lane, Harrison, AR 72601 | 2017-09-19 |
| 1306394465 | Rebecca Jane Mcanulty | Nurse Practitioner | 702 N. Springs Street, Harrison, AR 72601 | 2016-09-19 |
| 1194174763 | Jessalyn Foy | Case Manager/Care Coordinator | 413 N Rowland St, Harrison, AR 72601 | 2016-06-06 |
| 1689022311 | Eva Laynette Norris | Case Manager/Care Coordinator | 114 E. Crandall, Harrison, AR 72601 | 2016-06-03 |
| 1760830491 | Jana Daniels | Case Manager/Care Coordinator | 9378a Hwy 7 North, Harrison, AR 72601 | 2016-06-03 |
| 1376992016 | Laken Nichole Curtis | Case Manager/Care Coordinator | 5985 James Phifer Ln, Harrison, AR 72601 | 2016-06-03 |
| Find all providers in zip 72601 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213102 | Paige Conner Malick | Physician Assistant | 33 Purdy St Apt 2, Harrison, NY 10528-3735 | 2020-10-20 |
| 1043588650 | Danielle Nicole Maucieri | Physician Assistant | 17 Gleason Pl, Harrison, NY 10528-4603 | 2011-12-09 |
| 1770773715 | Kimberly Kay Regnier | Physician Assistant | 119 West Central, Harrison, AR 72601 | 2007-07-26 |
| 1639273311 | Diane Grove | Physician Assistant | 815 N Clare Ave, Harrison, MI 48625-9194 | 2006-09-12 |
| 1629003736 | Anthony Joseph Rose | Physician Assistant | 224 West Erie, Harrison, AR 72601 | 2006-07-11 |
| 1881178465 | Jamie Walderzak | Physician Assistant | 815 N Clare Ave, Harrison, MI 48625-8176 | 2018-09-20 |
| 1659773547 | Jennifer Schlitzkus | Physician Assistant | 815 N Clare Ave, Harrison, MI 48625-9194 | 2014-09-23 |
| 1194095448 | Jesse A Larbey | Physician Assistant | 620 North Main, Harrison, AR 72601-2911 | 2012-01-04 |
| 1023118601 | Anthony Santini | Physician Assistant | 815 N Clare Ave, Harrison, MI 48625-9194 | 2006-09-24 |
| 1497771257 | Courtney Leonard Kuhn | Physician Assistant | 600 Mamaroneck Ave, Suite 101, Harrison, NY 10528-1635 | 2006-07-14 |
| Find all providers in HARRISON | ||||
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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.