Marisa Johnson, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD.023908 Issued in LA

Practice address

1303 Line Ave
Ste 400
Shreveport, LA 71101-4628

Phone

(318) 221-2707

Fax

(313) 221-2709

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA, WY, MS, MI, OH, AL, TN, GA, WV, KY10 enrollments

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 10

Specialty

Nephrology

Education

University of Arkansas College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.9 of 100Reported as group

Quality

68.13

Promoting interoperability

99

Improvement activities

40

Cost

69.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marisa.johnson.1@22854.direct.athenahealth.com

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.

• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1134739089

  KY, MI, OH, WV

  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1255930228

  GA

  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1326655986

  MS

  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1336748300

  AL

  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1659987436

  LA

  Medicare reassignment NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1083615520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 LINE AVE",
            "address_2": "STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014628",
            "telephone_number": "318-221-2707",
            "fax_number": "313-221-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 LINE AVE",
            "address_2": "STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014628",
            "telephone_number": "318-221-2707",
            "fax_number": "313-221-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "L6967",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "023908",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "MD.023908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146986802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487481",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Johnson
• Lisa Diane Johnson
• Lori R Johnson, MD
• Lydia Johnson
• Marilyn Johnson, MS
• Marlaysha Rae'Nae Johnson, B.S
• Marsha Johnson
• Martinez Johnson, MHS
• Megan O'Dell Johnson
• Melvie March Johnson

• Nephrology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nephrology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.