Individual provider Active NPI

Bridgette Stewart Johnson, NP

  • Family Nurse Practitioner
  • Gretna, LA
National Provider Identifier
1376811067
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN075634-AP06689 Issued in LA
Practice address
837 Oakwood Dr
Gretna, LA 70056-4510
Phone
(504) 416-4763
Fax
(504) 680-0213
NPI assigned
Dec 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN075634-AP06689 LA Primary

Addresses

Primary practice location

837 Oakwood Dr
Gretna, LA 70056-4510

Mailing address

837 Oakwood Dr
Gretna, LA 70056-4510
Phone (504) 416-4763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20120501000078 LA Practitioner - Nurse Practitioner 8022270479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Community Health Care Centers, IncGroup PAC ID 7911961115, 17 clinicians

Practice addresses (Care Compare)

3932 Hwy 90 W
Avondale, LA 70094-2648
Phone (504) 436-2223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN075634-AP06689LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Community Health Care Centers Inc CurrentSince Feb 5, 2024 Accepting new patients
Jefferson Community Health Care Centers, Inc Current Accepting new patients
Jefferson Community Health Care Centers, Inc CurrentSince Feb 5, 2024 Accepting new patients
Jefferson Community Health Care Centers, Inc. Past Accepting new patients

Locations

4028 Highway 90 W
Avondale, LA 70094
Phone (504) 436-2223

7001 Lapalco Blvd
Marrero, LA 70072
Phone (504) 341-4006

3932 Highway 90 W
Westwego, LA 70094
Phone (504) 302-1589

Interoperability endpoints

  • Direct secure messaging: bridgett.johnson.1@12324.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1376811067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 OAKWOOD DR",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700564510",
            "telephone_number": "504-416-4763",
            "fax_number": "504-680-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 OAKWOOD DR",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700564510",
            "telephone_number": "504-416-4763",
            "fax_number": "504-680-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIDGETTE",
        "middle_name": "STEWART",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN075634-AP06689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.