Lakreese Johnson, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601005679 Issued in MI

Practice address

3855 Cooper St
Jackson, MI 49201-7547

Phone

(517) 780-5991

NPI assigned

Jun 6, 2010

Last updated

Dec 13, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lajohnson@ahcdetroit.directbygreenway.com

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.

• Geriatric Psychiatric Services PLLC

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1073753323
  NPD (past)

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1508186156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 COOPER ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017547",
            "telephone_number": "517-780-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 COOPER ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017547",
            "telephone_number": "517-780-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAKREESE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-06",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5601005679",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• De'Sharrah Johnson, CHW
• Delia Johnson, LMSW
• Denise June Johnson, LPC, NCC
• Derek Johnson, PHARMD
• Jillian Johnson
• Mackenzie Johnson
• Michele Johnson, DO
• Rachele Renee Johnson
• Rose Johnson, MD
• Sarah Johnson, BCBA

• Medical Physician Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.