Charla V Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003556 Issued in GA

Practice address

950 Eagles Landing Pkwy
Suite 212
Stockbridge, GA 30281-7343

Phone

(404) 307-3062

NPI assigned

Sep 21, 2006

Last updated

Aug 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Charla V Shelby Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment
• Noah's Ark Urgent Care LLC

  • Urgent Care Clinic/Center
  • Stockbridge, GA
  • NPI 1083160436
  Authorized official Same address or phone
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1033218581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 EAGLES LANDING PKWY",
            "address_2": "SUITE 212",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343",
            "telephone_number": "404-307-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 EAGLES LANDING PKWY",
            "address_2": "SUITE 212",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343",
            "telephone_number": "404-307-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLA",
        "middle_name": "V",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667084523B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLA",
            "last_name": "SHELBY",
            "middle_name": "V",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John C.Vencill O.D., P.C.
• Tamika Johnnicans, NURSE PRACTITIONER
• C J Johnson, PSYD
• Candace J Johnson, M.D.
• Candice Johnson
• Courtney Nicole Johnson, D.P.T.
• Denetra Johnson
• Jamia Joy Johnson
• Jasmine Johnson, DPT
• Jessica Charles Johnson, BCBA

• Medical Physician Assistant in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.