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

Zackery Johnson

Individual provider Family Nurse Practitioner · NPI 1336767748

Zackery Johnson is a Nurse Practitioner in Hattiesburg, Mississippi. Qualified in 2020, 6 years ago. Practices with MS Pain and Migraine, a 6-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
6
Licensed in
MS
In the registry since
2020
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Practice location Address checks out

6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone: (601) 288-4242
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence JOHN-5CVAJZ (MS)

Record details

NPI number1336767748
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 12, 2020
Last updated in NPPESJuly 12, 2020
Certification dateJuly 12, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ms Pain And Migraine — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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