Individual provider Active NPI

R. Mollie A. John, M.D.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Monroe, LA
National Provider Identifier
1942366729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
10383R Issued in LA
Practice address
2701 Brierfield Dr
Monroe, LA 71201-3048
Phone
(318) 387-1437
Fax
(318) 322-2685
NPI assigned
Dec 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 10383R LA Primary

Addresses

Primary practice location

2701 Brierfield Dr
Monroe, LA 71201-3048

Mailing address

2701 Brierfield Dr
Monroe, LA 71201-3048
Phone (318) 387-1437

Other identifiers 1

IdentifierTypeStateIssuer
1989258MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10383RLAMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R. Mollie a. John, M.D., Apmc Neuromusculoskeletal Medicine, Sports Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942366729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BRIERFIELD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013048",
            "telephone_number": "318-387-1437",
            "fax_number": "318-322-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BRIERFIELD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013048",
            "telephone_number": "318-387-1437",
            "fax_number": "318-322-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "R. MOLLIE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "LA",
            "license": "10383R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1989258",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.