Individual provider Active NPI

Patricia Marie Johnson, NP

  • Family Nurse Practitioner
  • Breaux Bridge, LA
National Provider Identifier
1861882920
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
08111 Issued in LA
Practice address
1451 E Bridge St
Breaux Bridge, LA 70517-3405
Phone
(337) 322-2210
Fax
(337) 322-2220
NPI assigned
Jan 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 08111 LA Primary

Addresses

Primary practice location

1451 E Bridge St
Breaux Bridge, LA 70517-3405

Mailing address

1451 E Bridge St
Breaux Bridge, LA 70517-3405
Phone (337) 332-2210

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pjohnson14648@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20150226001713 LA Practitioner - Nurse Practitioner 2466778030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

1451 E Bridge St
Breaux Bridge, LA 70517-3405
Phone (337) 332-2210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Institute of the South, LLC Nurse Practitioner CurrentSince Nov 30, 2022 Accepting new patients

Locations

1451 E Bridge St
Breaux Bridge, LA 70517
Phone (337) 322-2210

1901 Manhattan Blvd
Ste A200
Harvey, LA 70058
Phone (504) 354-5252

225 Dunn St
Houma, LA 70360
Phone (985) 446-2021

500 N Lewis St
Ste 100
New Iberia, LA 70563
Phone (337) 367-5200

Interoperability endpoints

  • Direct secure messaging: pjohnson1647700@direct.ochsner.org
  • Direct secure messaging: pjohnson14648@direct.casso.us.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1861882920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 E BRIDGE ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173405",
            "telephone_number": "337-332-2210",
            "fax_number": "337-332-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E BRIDGE ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173405",
            "telephone_number": "337-322-2210",
            "fax_number": "337-322-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "08111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjohnson14648@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pjohnson14648@direct.casso.us.com",
            "address_1": "548 Lakes Blvd",
            "city": "Breaux Bridge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "548 Lakes Blvd",
            "city": "Breaux Bridge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

Verify at the official NPI Registry.