| Dr Johnnie Jacqueline Wren, MD | |
|
15 Pleasant Street, Au Sable Forks, NY 21912 | |
| (518) 647-8164 | |
| Not Available |
| Full Name | Dr Johnnie Jacqueline Wren |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 9 Years |
| Location | 15 Pleasant Street, Au Sable Forks, New York |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073045746 | NPI | - | NPPES |
| 06303951 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 307989 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hcr / Hcr Home Care Chha (plattsburgh) | Plattsburgh, NY | Home health agency |
| Hospice Of The North Country Inc | Plattsburgh, NY | Hospice |
| Champlain Valley Physicians Hospital Medical Ctr | Plattsburgh, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Wind Primary Care Pllc | 4587066956 | 4 |
| Entity Name | Champlain Valley Physicians Hospital Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124189782 PECOS PAC ID: 2769396878 Enrollment ID: O20031121000623 |
| Entity Name | North Wind Primary Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629646690 PECOS PAC ID: 4587066956 Enrollment ID: O20210707002626 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Johnnie Jacqueline Wren, MD 159 Margaret St, Suite 100, Plattsburgh, NY 12901-1893 Ph: (518) 314-3939 | Dr Johnnie Jacqueline Wren, MD 15 Pleasant Street, Au Sable Forks, NY 21912 Ph: (518) 647-8164 |
Dr. Richard Louis Bremer, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 27 North Main Street, Au Sable Forks, NY 12912 Phone: 518-647-8164 Fax: 518-647-2127 | |
Laurel M Rosenthal, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 15 Pleasant St, Au Sable Forks, NY 12912 Phone: 518-647-8164 Fax: 518-647-2127 |