Dianne Jean-Marie Bennett-Johnson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

037957 Issued in GA

Practice address

483 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-3717

Phone

(770) 279-2427

Fax

(770) 279-0639

NPI assigned

Oct 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive Healthcare of Gwinnett LLC

  • General Practice Physician
  • Lilburn, GA
  • NPI 1174892392
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386724599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 PEACHTREE PKWY",
            "address_2": "SUITE 240-375",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923336",
            "telephone_number": "770-279-2427",
            "fax_number": "770-279-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473717",
            "telephone_number": "770-279-2427",
            "fax_number": "770-279-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-JOHNSON",
        "first_name": "DIANNE",
        "middle_name": "JEAN-MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "037957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00630638F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Believe & Conquer Therapeutic Services LLC
• Joi Aimee Bell-Blanding, WHNP
• Stacha Bell
• Bella Cosmetic and Family Dentistry
• Todd Bender, NP-C
• Danisha Bennett, NMT, LMT
• Katharine J Benton, PT, DPT
• Nardos A Benton, DMD
• Vanessa Bernal
• Better Total Care LLC

• Internal Medicine Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.