| Denetra Johnson, | |
|
5095 Mount Zion Pkwy, Stockbridge, GA 30281-7825 | |
| (401) 652-9787 | |
| (401) 652-9787 |
| Full Name | Denetra Johnson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 11 Years |
| Location | 5095 Mount Zion Pkwy, Stockbridge, Georgia |
| 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 |
|---|---|---|---|
| 1205207388 | NPI | - | NPPES |
| RN161105 | Other | GA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R865978 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN161105 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emergency Coverage Llc | 3072412592 | 530 |
| The Bortolazzo Group, Llc | 3476554320 | 84 |
| Inphynet Primary Care Physicians Southeast Pc | 3779497045 | 75 |
| Acs Primary Care Physicians - Southeast Pc | 5193620714 | 354 |
| Entity Name | Inphynet Primary Care Physicians Southeast Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770521460 PECOS PAC ID: 3779497045 Enrollment ID: O20031119000600 |
| Entity Name | Georgia Em-i Medical Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285682583 PECOS PAC ID: 0446157218 Enrollment ID: O20031218000621 |
| Entity Name | Acs Primary Care Physicians - Southeast Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861430555 PECOS PAC ID: 5193620714 Enrollment ID: O20040901000766 |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050411000056 |
| Entity Name | Hospital Physician Services - Southeast Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760410385 PECOS PAC ID: 5597774554 Enrollment ID: O20060419000545 |
| Entity Name | The Bortolazzo Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801965082 PECOS PAC ID: 3476554320 Enrollment ID: O20070122000015 |
| Entity Name | Walker Lake Emergency Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437629342 PECOS PAC ID: 0840531919 Enrollment ID: O20190418001186 |
| Entity Name | Small Hospital Innovations Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184040560 PECOS PAC ID: 0840415444 Enrollment ID: O20220404000661 |
| Mailing Address | Practice Location Address |
|---|---|
| Denetra Johnson, 5095 Mount Zion Pkwy, Stockbridge, GA 30281-7825 Ph: () - | Denetra Johnson, 5095 Mount Zion Pkwy, Stockbridge, GA 30281-7825 Ph: (401) 652-9787 |
Casey R. Black, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 125 Eagle Spring Dr, Stockbridge, GA 30281 Phone: 770-213-3366 Fax: 404-962-6943 | |
Ms. Rita Raynel Givens, FNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 830 Eagles Landing Pkwy Ste 204, Stockbridge, GA 30281 Phone: 770-962-3642 Fax: 770-962-3643 | |
Ms. Eleasha R Gray, C-FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 165 North Park Trail, Stockbridge, GA 30281 Phone: 770-506-1800 Fax: 770-389-5947 | |
Jeanine Clark, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 175 Medical Blvd, Stockbridge, GA 30281 Phone: 239-443-8018 | |
Sandra Thomas, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 950 Eagles Landing Pkwy # 210, Stockbridge, GA 30281 Phone: 770-668-3363 | |
Tricia Jarrell Morris, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 547 Winter View Way, Stockbridge, GA 30281 Phone: 678-272-0086 Fax: 678-489-6860 | |
Shanea R Mcdaniel, RN, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 552 Creek Valley Ct, Stockbridge, GA 30281 Phone: 803-617-9953 |