Jeremy M Johnson, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-5601

Fax

(601) 984-6601

NPI assigned

Apr 7, 2016

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

Medicare fee-for-service enrollment

Enrolled in MS

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

Emergency Medicine

Education

William Carey University College of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monroe Regional Hospital Hospital, Aberdeen, MS, CCN 251302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Medicare reassignment
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment

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

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Care Compare affiliation

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1669836540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5601",
            "fax_number": "601-984-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5601",
            "fax_number": "601-984-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hardin Douglas Johnson, MD
• Hollye R Johnson, MD
• Jana Wilkerson Johnson, OT
• Jennifer Johnson, FNP-C
• Jennifer Johnson, LCSW
• Joyce Johnson, LCSW
• Juli K. Johnson, CRNA
• Kathleen Nicole Johnson, MD
• Katrina Louise Johnson, MD
• Kayla Johnson, RBT

• Student in an Organized Health Care Education/Training Program in Jackson, MS
• Providers in Jackson, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.