MR. DERRICK M JOHNSON (NPI# 1588784565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588784565 |
| Entity Type | Individual |
| Full Name | MR. DERRICK M JOHNSON |
| Credential | PA |
| Practice Address |
454 Taylor Rd Montgomery AL 36117-3563 |
| Practice Telephone | 3346139000 |
| Practice Fax Number | 3345320056 |
| Mailing Telephone | 3346139000 |
| Mailing Fax Number | 3345320056 |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2014-01-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 162 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285099473 | Derrick Johnson | Behavioral Analyst | 5725 Palma Ln, Greenwood, FL 32443-2421 | 2015-12-15 |
| 1750608634 | Derrick Johnson | Marriage & Family Therapist | 1606 Ambassador Dr, Reno, NV 89523-1215 | 2010-04-30 |
| 1942473186 | Derrick Jerod Johnson | Audiologist | 7601 Matapeake Business Drive, Brandywine, MD 20613 | 2008-04-09 |
| 1497896674 | Derrick James Johnson | Counselor | 1022 Madison, Oak Park, IL 60302 | 2007-02-09 |
| 1407963762 | Derrick V Johnson | Dentist | 114 Dyer Street, Mountain Home, AR 72653 | 2006-08-24 |
| 1841723301 | Derrick Johnson | Behavior Technician | 4606 Lee St, Alexandria, LA 71302-3235 | 2017-04-11 |
| 1891983623 | Derrick E. Johnson | Internal Medicine | 7277 Smiths Mill Rd, #250, New Albany, OH 43054-8195 | 2007-10-05 |
| 1588859599 | Derrick J. Johnson | Physical Therapist | 717 W 3rd St, Elk City, OK 73644-5207 | 2007-09-12 |
| 1609093277 | Derrick Bernard Johnson | Physician Assistant | 2925 Palo Verde Ave, Long Beach, CA 90815-1552 | 2007-04-18 |
| Street Address |
454 TAYLOR RD |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36117-3563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790744589 | Joseph F Curtis Jr. | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2006-03-21 |
| 1023547833 | Manuel Escobar | Nurse Practitioner | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2017-06-06 |
| 1558780411 | Thomas Rutherford Sellers | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2014-04-08 |
| 1174945539 | Antoinette Love | Physician Assistant | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2014-01-20 |
| 1609117266 | Perry Oliver Hooper IIi | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2013-03-07 |
| 1770727497 | Lauren Lane Bannon | Physician Assistant | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2009-04-24 |
| 1205070901 | Robert Edgar Howell IIi | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2009-04-24 |
| 1962699611 | Southern Orthopaedic Surgeons, LLC | Durable Medical Equipment & Medical Supplies | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2007-09-26 |
| 1245315308 | Christopher Andrew Heck | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2006-10-26 |
| 1700974904 | Jason Thomas Randall | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061307 | Bhg Lxxiii, LLC | Clinic/Center | 1714 Platt Place, Montgomery, AL 36117 | 2020-10-22 |
| 1952945602 | East Montgomery Pediatrics LLC | Pediatrics | 337 St Lukes Drive, Montgomery, AL 36117 | 2019-11-05 |
| 1417421496 | Tiffany Webb | Specialist | 411 Twain Curve, E, Montgomey, AL 36117 | 2019-01-14 |
| 1013485374 | Montgomery Orthodontic Specialists | Dentist | 5833 Carmichael Road, Montgomery, AL 36117 | 2018-11-05 |
| 1770050791 | Blair Henderson Parks | Speech-Language Pathologist | 7088 University Court, Montgomery, AL 36117 | 2018-10-29 |
| 1629557822 | Evelyn F Crayton | Dietitian, Registered | 124 Elm Dr, Montgomery, AL 36117 | 2018-08-08 |
| 1194203414 | Coopers Mental Healh Consultations | Psychologist | 8743 Ridgestone Ct, Montgomery, AL 36117 | 2018-07-30 |
| 1063912301 | Gardenia Cove Mental Health PC | Psychiatry & Neurology | 6771 Taylor Circle, Montgomery, AL 36117 | 2018-02-13 |
| 1760900294 | Montgomery Auburn Homecare LLC | In Home Supportive Care | 2569 Bell Rd, Montgomery, AL 36117 | 2017-09-05 |
| 1336667120 | Alyssa Bryanna Swisher | Chiropractor | 2026 Berryhill Road, Montgomery, AL 36117 | 2017-09-01 |
| Find all providers in zip 36117 | ||||
| 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 |
|---|---|---|---|---|
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1154803179 | Ashley Goad | Physician Assistant | 269 Lakeside Hills Dr, Montgomery, TX 77316-6895 | 2018-09-06 |
| 1831550003 | Ruchi Patel | Physician Assistant | 2060 Berryhill Road, Montgomery, AL 36117 | 2016-03-15 |
| 1346600939 | Patrick Tyler Pair | Physician Assistant | 440 Taylor Rd Ste 3380, Montgomery, AL 36117-3587 | 2016-02-25 |
| 1720403066 | Suzanne Cullers | Physician Assistant | 18059 Highway 105 W Ste 120, Montgomery, TX 77356-5001 | 2014-02-24 |
| 1790110690 | Lisa Diane Vatani | Physician Assistant | 59 La Costa Dr, Montgomery, TX 77356-5352 | 2013-09-10 |
| 1447594296 | Kristina Nancy Hajek | Physician Assistant | 1851 Douglas Road, Montgomery, IL 60538 | 2012-11-17 |
| 1235488289 | Kristin L Sponaugle | Physician Assistant | 1898 Mulberry St, Montgomery, AL 36106-1526 | 2012-09-06 |
| 1457626111 | Jeremy Romine | Physician Assistant | 3101 Tine Ave, Montgomery, AL 36108-2309 | 2012-03-14 |
| 1184680431 | Trudie Dianne Seirafi | Physician Assistant | 4250 Carmichael Ct N, Montgomery, AL 36106-2874 | 2006-04-25 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36117 |
Please comment or provide details below to improve the information on MR. DERRICK M 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.