Annelle Rae Johnson, MD

Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Van Alstyne, TX

NPI 1386670313 · NPPES record last updated Sep 19, 2011

Key facts

NPI
1386670313
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Medicine (Family Medicine) Physician 207QG0300X
License
N8798 (TX)
Practice address
350 N Cartwright Rd
Van Alstyne, TX 75495-7111
Phone
(903) 482-9153
Fax
(903) 482-9514
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Serafini Medical, P.C. Past
since Oct 20, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2009017805 MO
Geriatric Medicine (Family Medicine) Physician 207QG0300X N8798 TX Yes

Addresses

Primary practice location

350 N Cartwright Rd
Van Alstyne, TX 75495-7111

Mailing address

350 N Cartwright Rd
Van Alstyne, TX 75495-7111

Other identifiers

IdentifierTypeStateIssuer
200653200AMedicaidKS
281322202MedicaidTX
1386670313MedicaidMO

Other providers in Van Alstyne, TX

All providers in Van Alstyne, TX · Geriatric Medicine (Family Medicine) Physician in Texas

Sources for this page

Verify at the official NPI Registry.