| John Derek Johnson, MD | |
|
180 Ninth St, Lasalle Family Medicine Clinic, Jena, LA 71342-3900 | |
| (318) 992-9200 | |
| Not Available |
| Full Name | John Derek Johnson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 14 Years |
| Location | 180 Ninth St, Jena, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619234945 | NPI | - | NPPES |
| 2188658 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 206647 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lasalle Gen Hosp Home Health Agency | Jena, LA | Home health agency |
| Louisiana Homecare Of Miss-lou | Ferriday, LA | Home health agency |
| All Saints Hospice | Marksville, LA | Hospice |
| Lasalle General Hospital | Jena, LA | Hospital |
| Christus St Frances Cabrini Hospital | Alexandria, LA | Hospital |
| Central Louisiana Surgical Hospital | Alexandria, LA | Hospital |
| Lasalle Nursing Home | Jena, LA | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hospital Service District 2 Of Lasalle Parish | 3971596164 | 14 |
| Jena Ess Hospitalist Llc | 5294954533 | 4 |
| Lsumc-s Family Practice Medical | 7719885367 | 10 |
| Entity Name | Lsumc-s Family Practice Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992888101 PECOS PAC ID: 7719885367 Enrollment ID: O20031222000187 |
| Entity Name | Hospital Service District #2 Of Lasalle Parish |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801825005 PECOS PAC ID: 3971596164 Enrollment ID: O20040628001134 |
| Entity Name | Emergency Staffing Solutions Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20050610000177 |
| Entity Name | Ess Hospitalist Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881967305 PECOS PAC ID: 6103085295 Enrollment ID: O20130515000072 |
| Entity Name | Jena Ess Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235544115 PECOS PAC ID: 7810116258 Enrollment ID: O20140916002675 |
| Entity Name | Jena Ess Hospitalist Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144635020 PECOS PAC ID: 5294954533 Enrollment ID: O20140918000317 |
| Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
| Mailing Address | Practice Location Address |
|---|---|
| John Derek Johnson, MD Po Box 2780, Lasalle Family Medicine Clinic, Jena, LA 71342-2780 Ph: (318) 992-9200 | John Derek Johnson, MD 180 Ninth St, Lasalle Family Medicine Clinic, Jena, LA 71342-3900 Ph: (318) 992-9200 |