Active NPI
Gus Johnson Jr.
- Personal Care Attendant
- Natchitoches, LA
National Provider Identifier
1386836948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 10952
- Practice address
- 750 Ouida Dr
Natchitoches, LA 71457-5446 - Phone
- (318) 352-5961
- Fax
- (318) 352-5965
- NPI assigned
- Aug 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 10952 | LA | Primary |
Addresses
Primary practice location
750 Ouida Dr
Natchitoches, LA 71457-5446
Mailing address
750 Ouida Dr
Natchitoches, LA 71457-5446
Phone (318) 352-5961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008869 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10952 | LA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187222400000",
"number": "1386836948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 OUIDA DR",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714575446",
"telephone_number": "318-352-5961",
"fax_number": "318-352-5965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 OUIDA DR",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714575446",
"telephone_number": "318-352-5961",
"fax_number": "318-352-5965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "GUS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-16",
"last_updated": "2007-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "LA",
"license": "10952",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008869",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Natchitoches, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.