Genesis Nephrology, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

023908 Issued in LA

Legal business name

GENESIS NEPHROLOGY, LLC

Practice address

1560 Irving PL
Shreveport, LA 71101-4604

Phone

(318) 221-2707

Fax

(318) 221-2709

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marisa Turner Johnson, MD

Title

Physician

Phone

(318) 221-2707

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1285881508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014604",
            "telephone_number": "318-221-2707",
            "fax_number": "318-221-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014604",
            "telephone_number": "318-221-2707",
            "fax_number": "318-221-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS NEPHROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARISA",
        "authorized_official_middle_name": "TURNER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-221-2707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "023908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.