| Rachel Johnson, CRNA | |
|
101 Hospital Dr, Tylertown, MS 39667-2021 | |
| (601) 827-5075 | |
| (601) 827-5133 |
| Full Name | Rachel Johnson |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 9 Years |
| Location | 101 Hospital Dr, Tylertown, 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 |
|---|---|---|---|
| 1972031227 | NPI | - | NPPES |
| 02906069 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 904536 (Mississippi) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 901435 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| South Central Reg Med Ctr | Laurel, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Central Clinics, Inc | 4385876655 | 108 |
| Entity Name | Southern Eye Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417112277 PECOS PAC ID: 9931278637 Enrollment ID: O20080521000442 |
| Entity Name | Lifelinc Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801021464 PECOS PAC ID: 0941347447 Enrollment ID: O20130522000277 |
| Entity Name | South Central Clinics, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801226287 PECOS PAC ID: 4385876655 Enrollment ID: O20140515000834 |
| Entity Name | Southern Eye Surgery And Laser Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295244226 PECOS PAC ID: 5496030595 Enrollment ID: O20171114002076 |
| Entity Name | Sweet Dreams Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427667724 PECOS PAC ID: 1254757685 Enrollment ID: O20200817002170 |
| Mailing Address | Practice Location Address |
|---|---|
| Rachel Johnson, CRNA 120 5th Ave, Mccomb, MS 39648-4159 Ph: (601) 444-9266 | Rachel Johnson, CRNA 101 Hospital Dr, Tylertown, MS 39667-2021 Ph: (601) 827-5075 |