Jesse Wayne Johnson Jr. (NPI# 1245344571, PAC ID# 5597757161) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1245344571 |
| PAC ID by PECOS | 5597757161 |
| Professional Enrollment ID | I20080910000530 |
| Full Name | Jesse Wayne Johnson Jr. |
| Organization Legal Name | HEATHROW INTERNAL MEDICINE LLC |
| Address |
4106 W Lake Mary Blvd Suite 100 Lake Mary FL 32746-3344 |
| Phone Number | 4073332273 |
| Gender | M |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 5294801536 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100161 | CENTRAL FLORIDA REGIONAL HOSPITAL |
| 100007 | FLORIDA HOSPITAL |
| 100057 | FLORIDA HOSPITAL WATERMAN |
| 100045 | FLORIDA HOSPITAL DELAND |
| Address | Phone | Organization |
|---|---|---|
| 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 | 4073332273 | HEATHROW INTERNAL MEDICINE LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | HEATHROW INTERNAL MEDICINE LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel R Monette | Family Medicine | Heathrow Internal Medicine LLC | 2209 S French Ave, Sanford, FL 32771-4245 |
| Edward J Magee | Family Medicine | Heathrow Internal Medicine LLC | 910 Williston Park Pointe, 2050 Family Practice of Lake Mary, Lake Mary, FL 32746-2128 |
| Michelle A Cooley | Nurse Practitioner | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| Manpreet K Gill | Family Medicine | Heathrow Internal Medicine LLC | 2209 S French Ave, Sanford, FL 32771-4245 |
| Elena M Gabor | Internal Medicine | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| James E Quinn | Family Medicine | Heathrow Internal Medicine LLC | 2209 S French Ave, Sanford, FL 32771-4245 |
| Vina B Gohill | Family Medicine | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| Kristy Jo Magee | Family Medicine | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| Aleksandra Clayton | Family Medicine | Heathrow Internal Medicine LLC | 910 Williston Park Pointe, 2050 Family Practice of Lake Mary, Lake Mary, FL 32746-2128 |
| Dennis C Blanchette | Family Medicine | Heathrow Internal Medicine LLC | 2209 S French Ave, Sanford, FL 32771-4245 |
| Street Address |
4106 W LAKE MARY BLVD SUITE 100 |
| City | LAKE MARY |
| State | FL |
| Zip | 32746-3344 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robin L Rahm | General Surgery | 4106 W Lake Mary Blvd, Suite 213, Lake Mary, FL 32746-2403 | |
| John F. Ryan | Internal Medicine | Florida Internal Medicine Pa | 4106 W Lake Mary Blvd, Suite 301, Lake Mary, FL 32746-3344 |
| Candace Glenn | Dermatology | Mid-florida Dermatology Associates P.a. | 4106 W Lake Mary Blvd, Suite 324, Lake Mary, FL 32746-3344 |
| Colleen M Mcgovern | Nurse Practitioner | Central Florida Cardiology Group Pa | 4106 W Lake Mary Blvd, Suite 312, Lake Mary, FL 32746-3344 |
| Michelle A Cooley | Nurse Practitioner | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| Charles N Witten | Urology | Central Florida Urology Associates | 4106 W Lake Mary Blvd, Suite 215, Lake Mary, FL 32746-3344 |
| Brian K Dublin | Cardiovascular Disease (cardiology) | Central Florida Cardiology Group Pa | 4106 W Lake Mary Blvd, Suite 312, Lake Mary, FL 32746-3344 |
| David Jason Hancock | Podiatry | Timothy P Mason Dpm Pa | 4106 W Lake Mary Blvd, Suite 125, Lake Mary, FL 32746-3383 |
| Elena M Gabor | Internal Medicine | Heathrow Internal Medicine LLC | 4106 W Lake Mary Blvd, Suite 100, Lake Mary, FL 32746-3344 |
| Vikram Prakash Mehta | Hand Surgery | 4106 W Lake Mary Blvd, Suite 224, Lake Mary, FL 32746-2403 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wilberto L Lopez | Cardiovascular Disease (cardiology) | The Cardiovascular Center, P.a. | 910 Williston Park Point, Suite 1000, Lake Mary, FL 32746 |
| Carlos P Grullon | Cardiovascular Disease (cardiology) | The Cardiovascular Center, P.a. | 910 Williston Park Point, Suite 1000, Lake Mary, FL 32746 |
| Lawrence E Vallario | Cardiovascular Disease (cardiology) | The Cardiovascular Center, P.a. | 910 Williston Park Point, Suite 1000, Lake Mary, FL 32746 |
| Mulugeta Fissha | Interventional Cardiology | The Cardiovascular Center, P.a. | 910 Williston Park Point, Suite 1000, Lake Mary, FL 32746 |
| William J David | Cardiovascular Disease (cardiology) | The Cardiovascular Center, P.a. | 910 Williston Park Point, Suite 1000, Lake Mary, FL 32746 |
| Stephen M Reed | Orthopedic Surgery | Florida Orthopaedic Associates Pa | 1337 S International Pkwy, Suite 1341, Lake Mary, FL 32746-1402 |
| Benjamin Golden Thomasson | Orthopedic Surgery | Florida Orthopaedic Associates Pa | 1337 S International Pkwy, Suite 1341, Lake Mary, FL 32746-1402 |
| Robert Frances Love | Optometry | 1331 S International Pkwy, Suite 1271, Lake Mary, FL 32746-1405 | |
| Jorge O Diaz | Cardiac Electrophysiology | Jorge O Diaz Md Pa | 1331 S International Pkwy, Suite 1261, Lake Mary, FL 32746-1405 |
| Rafael E Pena | Cardiac Electrophysiology | Jorge O Diaz Md Pa | 1331 S International Pkwy, Suite 1261, Lake Mary, FL 32746-1405 |
| Find all physicians in zip 32746 | |||
| City | LAKE MARY |
| Zip Code | 32746 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LAKE MARY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Jesse Wayne Johnson Jr..
| 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.