Individual provider Active NPI

Mikhala Juno Moriah Johns, PA

  • Surgical Physician Assistant
  • Savannah, GA
National Provider Identifier
1003542697
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
11038 Issued in GA
Practice address
4 E Jackson Blvd
Savannah, GA 31405-5895
Phone
(912) 355-1010
NPI assigned
Jul 27, 2022
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11038 GA
Surgical Physician Assistant 363AS0400X 11038 GA Primary

Addresses

Primary practice location

4 E Jackson Blvd
Savannah, GA 31405-5895

Mailing address

4 E Jackson Blvd
Savannah, GA 31405-5895
Phone (912) 355-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014001499 GA Practitioner - Physician Assistant 6608242730 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4 E Jackson Blvd
Savannah, GA 31405-5810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Neurological Institute of Savannah & Center for Spine, PC CurrentSince Sep 18, 2023 Accepting new patients
The Neurological Institute of Savannah & Center for Spine P C CurrentSince Sep 18, 2023 Accepting new patients
Pedsnow LLC PastSince Jul 31, 2023 Accepting new patients
Pedsnow LLC PastSince Jul 1, 2022 Accepting new patients

Locations

4 E Jackson Blvd
Savannah, GA 31405

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1003542697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055895",
            "telephone_number": "912-355-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055895",
            "telephone_number": "912-355-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "MIKHALA",
        "middle_name": "JUNO MORIAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11038",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "11038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.