JERRY L JOHNSON MD PA - NPI 1174824510 - Obstetrics & Gynecology in Lufkin, TX

Q: What is Jerry L Johnson MD PA's NPI number?

The NPI number for Jerry L Johnson MD PA is 1174824510. It was assigned to this organization in the NPPES registry on November 16, 2010.

Q: What is Jerry L Johnson MD PA's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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About Jerry L Johnson Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY L JOHNSON MD PA (NPI 1174824510) is a healthcare organization registered as an obstetrics & gynecology in Lufkin, Texas and active in the NPI registry since November 2010. The organization holds a CLIA Microscopy certificate valid through December 22, 2027 and lists Jerry L Johnson, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1174824510

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameJERRY L JOHNSON MD PA

Location Address503 S JOHN REDDITT DRLufkin, TX 75904-3120

Mailing Address503 S John Redditt DrLufkin, TX 75904-3120 · (936) 632-1533 · Fax (936) 632-1726

Phone(936) 632-1533

Fax(936) 632-1726

Organization SubpartNo

Authorized OfficialJerry L JohnsonMd/owner · (936) 632-1533

Enumeration DateNovember 16, 2010

Last NPPES UpdateSeptember 6, 2012

✔ NPI 1174824510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in TX · J2117

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

503 S JOHN REDDITT DR, Lufkin, TX 75904

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0968853

Dr Jerry Johnson · Lufkin, TX

Active · expires Dec 22, 2027

CLIA Number45D0968853

Laboratory TypePhysician Office

Certificate Effective DateDecember 23, 2025

Certificate Expiration DateDecember 22, 2027

Laboratory DirectorJerry Johnson MD

Laboratory Phone(409) 632-1533

Laboratory LocationDr Jerry Johnson503 South John Redditt Drive, Lufkin, TX 75904

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLIE RAE MERRITT FNP

Nurse Practitioner (Family)