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MARISA JOHNSON MD NPI 1083615520


NPI Information

NPI: 1083615520
Provider Name: MARISA JOHNSON, MD
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
1303 LINE AVE
STE 400
SHREVEPORT, LA
ZIP 71101
Phone: (318) 221-2707
Get Directions

Marisa Johnson, MD is a nephrology internal medicine in Shreveport, LA with 27 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Marisa Johnson, MD NPI is 1083615520. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year:1997

The provider's business location address is:

1303 LINE AVE
STE 400
SHREVEPORT, LA
ZIP 71101-628
Phone: (318) 221-2707
Fax: (313) 221-2709

The NPI 1083615520 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services (4 or more physician visits per month), patient 20 years of age and older (HCPCS:90960)
  • Hemodialysis procedure with one physician evaluation (HCPCS:90935)
  • Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)

The enumeration date for this NPI number is 8/9/2005 and was last updated on 9/6/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyL6967TEXASNo
2207RN0300XInternal MedicineNephrology023908LOUISIANANo
3207RN0300XInternal MedicineNephrologyMD.023908LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18A9377MEDICARE ID-TYPE UNSPECIFIED
2H46621MEDICARE UPIN
3146986802MEDICAIDTEXAS
41487481MEDICAIDLOUISIANA
54A598CC98MEDICARE PINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.