| Hollye R Johnson, MD | |
|
6501 Dogwood View Parkway, Suite A, Jackson, MS 39213 | |
| (601) 899-3340 | |
| (601) 899-3343 |
| Full Name | Hollye R Johnson |
|---|---|
| Gender | Female |
| Speciality | Nephrology |
| Experience | 29 Years |
| Location | 6501 Dogwood View Parkway, Jackson, Mississippi |
| 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 |
|---|---|---|---|
| 1700815321 | NPI | - | NPPES |
| 04056301 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 15974 (Mississippi) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | 15974 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Isd Renal Inc | Canton, MS | Dialysis facility |
| Isd Renal Inc | Jackson, MS | Dialysis facility |
| Isd Renal Inc | Jackson, MS | Dialysis facility |
| Bio Medical Applications Of Mississippi, Inc | Clinton, MS | Dialysis facility |
| St Dominic-jackson Memorial Hospital | Jackson, MS | Hospital |
| Mississippi Baptist Medical Center | Jackson, MS | Hospital |
| Merit Health River Oaks | Flowood, MS | Hospital |
| Merit Health Central | Jackson, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Diversified Renal Group Llc | 6406815299 | 5 |
| Entity Name | Diversified Renal Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184792038 PECOS PAC ID: 6406815299 Enrollment ID: O20041007000414 |
| Mailing Address | Practice Location Address |
|---|---|
| Hollye R Johnson, MD 6501 Dogwood View Parkway, Suite A, Jackson, MS 39213 Ph: (601) 899-3340 | Hollye R Johnson, MD 6501 Dogwood View Parkway, Suite A, Jackson, MS 39213 Ph: (601) 899-3340 |
Graves Crawley Stubblefield Jr., M.D. Nephrology Medicare: Medicare Enrolled Practice Location: 406 Briarwood Dr, Jackson, MS 39206 Phone: 601-991-1933 Fax: 601-978-3844 | |
Dr. Rebecca Chick Pace, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 1200 N State St, Suite 500, Jackson, MS 39202 Phone: 601-352-2273 Fax: 601-714-3415 | |
Jewelian Akbar Baig, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 971 Lakeland Dr Ste 356, Jackson, MS 39216 Phone: 601-200-4644 Fax: 601-200-4645 | |
Jo P Deal, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 766 Lakeland Dr # A, Jackson, MS 39216 Phone: 601-368-3440 Fax: 601-368-3441 | |
Samuel Hammond Love, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 970 Lakeland Dr Ste 49, Jackson, MS 39216 Phone: 601-200-4850 Fax: 601-200-4838 | |
Meghan Alford Luter, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5532 | |
Dr. Taylor Brooke Winstead, MD, PHARMD Nephrology Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 |