Jerry L Johnson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

J2117 Issued in TX

Practice address

503 S John Redditt Dr
Lufkin, TX 75904-3120

Phone

(936) 632-1533

Fax

(936) 632-1726

NPI assigned

Nov 29, 2006

Sex

Male

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Texas Southwestern Medical School at Dallas, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jerry L Johnson MD PAGroup PAC ID 1153505383, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
• CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerry.johnson@cj.eclinicaldirectplus.com
• Direct secure messaging: jerry.johnson.1@1902.direct.athenahealth.com

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.

• Jerry L Johnson MD PA

  • Obstetrics & Gynecology Physician
  • Lufkin, TX
  • NPI 1174824510
  Medicare reassignment Care Compare group NPD Authorized official
• Memorial Health System of East Texas

  • Rural Acute Care Hospital
  • Lufkin, TX
  • NPI 1396746129
  NPD (past)
• Piney Woods Healthcare System, L.P.

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health System of East Texas

  • Rural Acute Care Hospital
  • Lufkin, TX
  • NPI 1396746129
  Care Compare affiliation
• Piney Woods Healthcare System, L.P.

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  Care Compare affiliation

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1487721858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 SOUTH JOHN REDDITT",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-634-6636",
            "fax_number": "936-632-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043120",
            "telephone_number": "936-632-1533",
            "fax_number": "936-632-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J2117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099143202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson and Johnson Investments of Onalaska, LLC
• Brandi Johnson, FNP-C
• Hailey Lorayne Johnson, RN, BSN, FNP-C
• Jacquelyn Suell Johnson
• Jena Lynn Johnson, MSN, APRN, FNP-C
• Kechera Johnson
• Kimberly Darnae Johnson, RN
• Leondra Johnson
• Luke Johnson, M.D., M.P.H.
• Nelda Johnson, RNNP

• Obstetrics & Gynecology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.