Zackery Johnson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

JOHN-5CVAJZ Issued in MS

Practice address

6051 U S Highway 49
Hattiesburg, MS 39401-7200

Phone

(601) 288-4242

NPI assigned

Jul 12, 2020

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ms Pain and MigraineGroup PAC ID 5496162026, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ms Pain & Migraine

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Hattiesburg, MS
  • NPI 1689270142
  Medicare reassignment Care Compare group NPD
• Relias Emergency Medicine Specialists of Hattiesburg LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1609409440
  Medicare reassignment NPD
• Ms Pain & Migraine

  • Pain Medicine Physician
  • Southaven, MS
  • NPI 1346098035
  NPD

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

{
    "created_epoch": "1594512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594512000000",
    "number": "1336767748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 HIGHWAY 48 E",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396677115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017200",
            "telephone_number": "601-288-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ZACKERY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-12",
        "last_updated": "2020-07-12",
        "certification_date": "2020-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "JOHN-5CVAJZ",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanon Hodges Johnson, SLP
• Skylarr Johnson, PCCSS
• Tatum Mayfield Johnson
• Tina Johnson, LCSW
• Wesley Johnson, DNP, CRNA
• Jones County Medical Supplies, Inc
• Jones County Medical Supplies, Inc
• Brittany Poole Jones, NP
• Charissa Leigh Jones, L.P.C.
• Chrystal B Jones

• Family Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.
• 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.