| Miranda C Johnston, PA | |
|
281 W 4th St, Independence, LA 70443-2386 | |
| (985) 878-0066 | |
| (985) 878-0626 |
| Full Name | Miranda C Johnston |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 24 Years |
| Location | 281 W 4th St, Independence, Louisiana |
| 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 |
|---|---|---|---|
| 1003857830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA.A10528.RX (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Our Lady Of The Lake Surgical Hospital | Slidell, LA | Hospital |
| Slidell Memorial Hospital | Slidell, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aust Medical Llc | 0749532984 | 3 |
| Entity Name | Northlake Medicine and Wellness Center, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073693958 PECOS PAC ID: 5597764183 Enrollment ID: O20061208000218 |
| Entity Name | Neuroscience & Pain Institute LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528203957 PECOS PAC ID: 1951464213 Enrollment ID: O20090113000242 |
| Entity Name | Laderer Physician Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518191188 PECOS PAC ID: 4082763396 Enrollment ID: O20090515000388 |
| Entity Name | Total Family Medical LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881026870 PECOS PAC ID: 3577792878 Enrollment ID: O20140304001071 |
| Entity Name | Kindl Works LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669926887 PECOS PAC ID: 6204124605 Enrollment ID: O20161114000108 |
| Entity Name | Aust Medical LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710468103 PECOS PAC ID: 0749532984 Enrollment ID: O20181016002433 |
| Entity Name | Avala Physician Network LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922694710 PECOS PAC ID: 8527472422 Enrollment ID: O20210204002726 |
| Mailing Address | Practice Location Address |
|---|---|
| Miranda C Johnston, PA 2057 White Myrtle Dr, Madisonville, LA 70447-9480 Ph: (985) 259-0822 | Miranda C Johnston, PA 281 W 4th St, Independence, LA 70443-2386 Ph: (985) 878-0066 |