Active NPI
Donetta Guillory Johnson, LCSW
- Clinical Social Worker
- Zachary, LA
National Provider Identifier
1013169739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10148
- Practice address
- 3651 Main Street
Zachary, LA 70791-0770 - Phone
- (225) 209-0850
- Fax
- (888) 620-5988
- NPI assigned
- Oct 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10148 | LA | |
| Clinical Social Worker | 1041C0700X | 10148 | LA | Primary |
Addresses
Primary practice location
3651 Main Street
Zachary, LA 70791-0770
Mailing address
PO Box 770
Zachary, LA 70791-0770
Phone (225) 209-0850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10148 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Providers for a Healthy Feliciana, Inc | Past | Accepting new patients | |
| Primary Care Providers for a Healthy Feliciana, Inc. | Past | Accepting new patients | |
| Primary Care Providers for a Healthy Feliciana, Inc | Past | Accepting new patients |
Networks
- TX HMO
- MS PPO
- MS PPO C-SNP
- MS PPO D-SNP
- TX HMO D-SNP
- LA PPO C-SNP
Interoperability endpoints
- donetta.johnson.p1@direct.rkmprimarycare.nextgenshare.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba RKM Loranger
- Federally Qualified Health Center (FQHC)
- Loranger, LA
- NPI 1710427455
-
dba Clinton Middle Health Center
- Federally Qualified Health Center (FQHC)
- Clinton, LA
- NPI 1871692483
-
dba Jackson Complex Health Center
- Federally Qualified Health Center (FQHC)
- Jackson, LA
- NPI 1437258043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1013169739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 770",
"city": "ZACHARY",
"state": "LA",
"postal_code": "707910770",
"telephone_number": "225-209-0850",
"fax_number": "888-620-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3651 MAIN STREET",
"city": "ZACHARY",
"state": "LA",
"postal_code": "707910770",
"telephone_number": "225-209-0850",
"fax_number": "888-620-5988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DONETTA",
"middle_name": "GUILLORY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-13",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "10148",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "10148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Zachary, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.