Terrance A Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18444 Issued in MS

Practice address

1128 Highland Parkway
Suite 200
Picayune, MS 39466-9197

Phone

(601) 358-9630

Fax

(601) 358-9640

NPI assigned

Aug 18, 2006

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djohnson2860@directpatientrecord.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1033223904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-358-9630",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 HIGHLAND PARKWAY",
            "address_2": "SUITE 200",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394669197",
            "telephone_number": "601-358-9630",
            "fax_number": "601-358-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERRANCE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03310041",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "3470981",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1425567",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djohnson2860@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1128 Highland Parkway",
            "address_2": "Suite 200",
            "city": "Picayune",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394669197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Randall Charles Jacob
• James J. Blount, III, MD
• James M Riser MD PA
• Melissa Jarvis, RPH
• Cynthia V Jean-Pierre, M.D.
• Laura Jones, M.ED. BCBA LBA
• Tara Jo Jones, DC
• Katherine Henry Justo, MD
• Kanif Group LLC (Value Drug Mart)
• Bonnie Elizabeth Keaton, OD

• Family Medicine Physician in Picayune, MS
• Providers in Picayune, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.