Charisse Lashaune Johnson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903697 Issued in MS

Practice address

4105 Hospital St
Pascagoula, MS 39581-5312

Phone

(228) 762-8946

NPI assigned

Aug 19, 2019

Last updated

May 2, 2020By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Snatchednspirit LLC

  • Medical Specialty Clinic/Center
  • Mobile, AL
  • NPI 1922629898
  NPD Authorized official
• Shapiro Dimitri Medical, LLC

  • Dermatology Physician
  • Meridian, MS
  • NPI 1124373030
  NPD (past)

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588377600000",
    "number": "1427605161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3993 COTTAGE HILL RD APT 19C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366094230",
            "telephone_number": "251-423-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-8946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 Gause Blvd W",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704604130",
            "country_code": "US",
            "telephone_number": "504-229-7454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3993 Cottage Hill Rd Apt 19C3993",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366098418",
            "country_code": "US",
            "telephone_number": "251-423-4376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARISSE",
        "middle_name": "LASHAUNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-120774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "208338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Altaf A Jamal, M. D.
• David Milton Jenkins, MD
• Cynthia A Jensen, ACNP
• John W Degroote PC
• John W. Benus Foot Clinic
• Juanita Suzanne Johnson, CRNA
• Matthew Milton Johnson, PHARMD
• Nikia Nicole Johnson
• Samantha Johnson
• Angela N Jones, CFNP

• Family Nurse Practitioner in Pascagoula, MS
• Providers in Pascagoula, 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 May 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.