Nicole Lynn Johnson (NPI# 1578951240, PAC ID# 4688995202) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1578951240 |
| PAC ID by PECOS | 4688995202 |
| Professional Enrollment ID | I20150609000118 |
| Full Name | Nicole Lynn Johnson |
| Organization Legal Name | BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC |
| Address |
15476 Dedeaux Rd Suite B Gulfport MS 39503-2637 |
| Phone Number | 2286793001 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0547155178 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250040 | SINGING RIVER HOSPITAL |
| 250123 | GARDEN PARK MEDICAL CENTER |
| 250007 | MERIT HEALTH BILOXI |
| Address | Phone | Organization |
|---|---|---|
| 1720 A Medical Park Dr, Suite 220, Biloxi, MS 39532-2127 | 2283929355 | BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC |
| 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 | 2286793001 | BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC |
| Organization Legal Name | BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC |
| Physicians | 40 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan Dwaine Brown | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Christopher A Burks | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 3615 Hospital St, Pascagoula, MS 39581-4112 |
| Matthew W Lewis | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 1720 A Medical Park Dr, Suite 220, Biloxi, MS 39532-2127 |
| William J Wenstrom | Nurse Practitioner | Bienville Orthopaedic Specialists, LLC | 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565-6771 |
| Charles J Winters | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 1720 A Medical Park Dr, Suite 220, Biloxi, MS 39532-2127 |
| Daniel Allen Wittersheim | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565-6771 |
| Alisha Helen Farrish | Physical Therapy | Bienville Orthopaedic Specialists, LLC | 1720 A Medical Park Dr, Suite 220, Biloxi, MS 39532-2127 |
| John K Drake | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565-6771 |
| Clarissa Picard | Occupational Therapy | Bienville Orthopaedic Specialists, LLC | 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565-6771 |
| Brittany R Mcelhaney | Nurse Practitioner | Bienville Orthopaedic Specialists, LLC | 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565-6771 |
| Street Address |
15476 DEDEAUX RD SUITE B |
| City | GULFPORT |
| State | MS |
| Zip | 39503-2637 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan Dwaine Brown | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Ricky D Roach | Podiatry | 15476 Dedeaux Rd, Gulfport, MS 39503-2637 | |
| Henry T Leis | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Ophelia Abrahams | Occupational Therapy | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Jason Lowery | Physician Assistant | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Eric Jason Graham | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Joseph Tyler Cox | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Duc Vinh Nguyen | Nurse Practitioner | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Benjamin P Watts | Physician Assistant | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Stephen Lee Ryder | Physician Assistant | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Clarence Ray Quave Jr. | Physical Therapy | Encore Rehabilitation Inc | 15476 B Dedeaux Rd, Gulfport, MS 39503-2637 |
| Cherryl D Purvis | Nurse Practitioner | Heart Hypertension Cholesterol and Diabetes Care LLC | 15444 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Joseph M Frame | Physical Therapy | 15444 Dedeaux Rd A, Gulfport, MS 39503-2637 | |
| Alvin Joseph Walsh Iii | Nurse Practitioner | Heart Hypertension Cholesterol and Diabetes Care LLC | 15444 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Tiffany Lewallen | Physical Therapy | Encore Rehabilitation Inc | 15476 B Dedeaux Rd, Gulfport, MS 39503-2637 |
| Deborah Thompson-spencer | Nurse Practitioner | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| George T Salloum | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Joel Tucker | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Alexander D Blevens | Orthopedic Surgery | Bienville Orthopaedic Specialists, LLC | 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637 |
| Forrest M Smith | Physical Therapy | Encore Rehabilitation Inc | 15476 B Dedeaux Rd, Gulfport, MS 39503-2637 |
| Find all physicians in zip 39503 | |||
| City | GULFPORT |
| Zip Code | 39503 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GULFPORT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Nicole Lynn Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.