Martha J Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R552992 Issued in MS

Practice address

1220 Jefferson St
Laurel, MS 39440-4355

Phone

(601) 426-4507

Fax

(601) 426-4228

NPI assigned

Jun 8, 2006

Last updated

Feb 11, 2014By 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 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• South Central Clinics, Inc

  dba Ellisville Medical Clinic

  • Family Medicine Physician
  • Ellisville, MS
  • NPI 1801226287
  Medicare reassignment NPD
• South Central Clinics, Inc

  dba South Central Urgent Care

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  NPD
• South Central Clinics, Inc

  dba South Central Family Medicine

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1669609111
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1700827250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6167",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "601-426-4507",
            "fax_number": "601-426-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARTHA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R552992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114833",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleveland Eric Johnson, M.D.
• Courteney Johnson, PMHNP
• Karla Johnson, CRNA
• Linda C Johnson, LPN
• Mari Johnson
• Stephen Johnson, D.O.
• Illisia Marie Johnston, NP-C
• Jones County Medical Supplies, Inc
• Jones County School
• Jones County School District

• Family Nurse Practitioner in Laurel, MS
• Providers in Laurel, 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 Feb 11, 2014; 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.