| Richard Johnson, CRNA | |
|
811 S Washington Ave, Marshall, TX 75670-5336 | |
| (903) 315-1488 | |
| Not Available |
| Full Name | Richard Johnson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 26 Years |
| Location | 811 S Washington Ave, Marshall, Texas |
| 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 |
|---|---|---|---|
| 1811945926 | NPI | - | NPPES |
| 140494904 | Medicaid | TX | |
| 86081U | Other | TX | BCBSTX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 613247 (Texas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP110601 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus Good Shepherd Medical Center | Longview, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Christus Good Shepherd Medical Center | 3779565544 | 30 |
| Endo Sedation Llc | 4789845363 | 270 |
| Entity Name | Christus Good Shepherd Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760908404 PECOS PAC ID: 3779565544 Enrollment ID: O20040604000400 |
| Entity Name | Endo Sedation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588931174 PECOS PAC ID: 4789845363 Enrollment ID: O20120406000221 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Johnson, CRNA 804 Scott Nixon Memorial Dr, Augusta, GA 30907-2464 Ph: (800) 394-4445 | Richard Johnson, CRNA 811 S Washington Ave, Marshall, TX 75670-5336 Ph: (903) 315-1488 |
Thomas William Krudewig, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 811 S Washington Ave, Marshall, TX 75670 Phone: 903-927-6770 Fax: 903-927-6377 | |
Arris Lee Slaughter Jr., CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 811 S Washington Ave, Marshall, TX 75670 Phone: 903-927-6770 Fax: 903-927-6377 | |
Mr. Stanley C Crawford, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 9742 Fm 2625 E, Marshall, TX 75672 Phone: 903-472-0023 | |
Mark Watson Adams, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 811 S Washington Ave, Marshall, TX 75670 Phone: 903-927-6770 Fax: 903-927-6377 |