MARISSA MARIE JOHNSON (NPI# 1396997862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396997862 |
| Entity Type | Individual |
| Full Name | MARISSA MARIE JOHNSON |
| Credential | P.A.-C. |
| Practice Address |
6620 Schaefer Rd Dearborn MI 48126-4502 |
| Practice Telephone | 3135823700 |
| Practice Fax Number | 3135823301 |
| Mailing Telephone | 3135823700 |
| Mailing Fax Number | 3135823301 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601003464 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073081345 | Marissa Noelle Johnson | Nurse Practitioner | 14820 N Rome Ave, Tampa, FL 33613-1542 | 2018-11-05 |
| 1184149825 | Marissa Ann Johnson | Chiropractor | 257 Prospect Ave Ste 16, West Orange, NJ 07052-4210 | 2017-08-03 |
| 1679921290 | Marissa Johnson | Specialist/Technologist | 7153 Us Highway 6, Linesville, PA 16424-8155 | 2016-05-25 |
| 1659992154 | Marissa Kay Johnson | Social Worker | 495 E Main St, Columbus, OH 43215-5349 | 2020-05-06 |
| 1477113678 | Marissa Johnson | Physical Therapist | 3145 W Clark Rd Ste 102, Ypsilanti, MI 48197-1120 | 2019-06-19 |
| 1588167324 | Marissa Johnson | Student in an Organized Health Care Education/Training Program | 5000 W Chambers St, Milwaukee, WI 53210-1650 | 2018-03-16 |
| 1447703525 | Marissa Irene Johnson | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2016-07-26 |
| 1386015626 | Marissa Johnson | Counselor | 1126 Sam Newell Rd, Suites C & D, Matthews, NC 28105-5083 | 2015-10-13 |
| 1629474028 | Marissa Johnson | Physician Assistant | 901 W Ben White Blvd, Suite 201, Austin, TX 78704-6903 | 2014-11-12 |
| 1053549337 | Marissa Johnson | Occupational Therapist | 17615 85th Avenue Ct E, Puyallup, WA 98375-1859 | 2009-06-25 |
| Street Address |
6620 SCHAEFER RD |
| City | DEARBORN |
| State | MI |
| Zip Code | 48126-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056068 | Dearborn Pediatric & Adolescent Medical Center, PC | Clinic/Center | 6620 Schaefer Rd, Dearborn, MI 48126-4502 | 2005-07-08 |
| 1629407168 | Dearborn Specialty Pharmacy Inc | Pharmacist | 6620 Schaefer Rd, Dearborn, MI 48126-4502 | 2013-11-05 |
| 1679655799 | Abeir Fouad Beydoun | Pharmacist | 6620 Schaefer Rd, Dearborn, MI 48126-4502 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1417501958 | Ximena Noemi Ortega | Behavior Technician | 6241 Miller Rd, Dearborn, MI 48126 | 2019-08-01 |
| 1912478827 | Abar Alghazali | Behavior Technician | 4641 Lois, Dearborn, MI 48126 | 2018-12-17 |
| 1861972457 | Laboratory Specialists of Michigan, LLC | Clinical Medical Laboratory | 13530 Michigan Ave Ste 240, Dearborn, MI 48126 | 2018-08-14 |
| 1528544806 | Farah Osman | Pharmacist | 14715 Ford Rd, Dearborn, MI 48126 | 2018-07-19 |
| 1255821328 | Loyal Pharmacy LLC | Pharmacy | 7118 Greenfield Rd St(b), Dearborn, MI 48126 | 2018-05-15 |
| 1952803900 | Neetika Kesar | Physical Therapist | 15051, Ford Road, Dearborn, MI 48126 | 2018-03-06 |
| 1396247607 | David Jerome Kurcz | Physical Therapy Assistant | 15051 Ford Road, Henry Ford Village, Dearborn, MI 48126 | 2018-03-02 |
| 1043732506 | Shadiya Ahmed | Dentist | 4700 Schaefer Rd Ste 190, Dearborn, MI 48126 | 2017-07-16 |
| Find all providers in zip 48126 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033345863 | Stephanie M Anselmi | Physician Assistant | 21516 Gregory St, Dearborn, MI 48124-3006 | 2009-06-08 |
| 1669636130 | Lisa A Boros-laurain | Physician Assistant | 3133 S.telegraph, Dearborn, MI 48124 | 2008-07-15 |
| 1912169343 | Amin Huballah | Physician Assistant | 7526 Wyoming St, Suite #2, Dearborn, MI 48126-1690 | 2008-06-26 |
| 1982743209 | Jessica Ashley Preston | Physician Assistant | 2100 Monroe St, Dearborn, MI 48124-2923 | 2007-02-05 |
| 1992863872 | Rocelious Goodson IIi | Physician Assistant | 4241 Maple St, Suite 200 D, Dearborn, MI 48126-3826 | 2006-12-04 |
| 1417995507 | Inshad Hassan Beydoun | Physician Assistant | 4789 Westland St, Dearborn, MI 48126-2809 | 2006-06-02 |
| 1215922109 | Houssam M Fadlallah | Physician Assistant | 6500 Schaefer Rd, Suite A, Dearborn, MI 48126 | 2005-09-16 |
| 1548816440 | Aisha Akilah Stokes | Physician Assistant | 6050 Greenfield Rd, Dearborn, MI 48126-6004 | 2019-08-15 |
| 1740753698 | Brittany N Glines | Physician Assistant | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2019-01-03 |
| 1689197659 | Rania Krayem | Physician Assistant | 6450 Maple St, Dearborn, MI 48126-2259 | 2017-07-21 |
| Find all providers in DEARBORN | ||||
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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.