Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles David Johnson, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1437538410

Charles David Johnson, AGACNP is a Nurse Practitioner in Hattiesburg, Mississippi. Qualified in 2015, 11 years ago. Practices with Comprehensive Radiology Services PLLC, a 50-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
11
Licensed in
MS
In the registry since
2015
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Practice location Address checks out

6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone: (601) 288-7000
Fax: (601) 450-0518
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence R875364 (MS)

Record details

NPI number1437538410
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMay 24, 2015
Last updated in NPPESJuly 28, 2023
Certification dateJuly 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Comprehensive Radiology Services Pllc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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