NPIMap

Individual provider Active NPI

Judah Charles Johnson, P.A.

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1053695957
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006258 Issued in GA
Practice address
811 13TH St
Suite 20
Augusta, GA 30901-2700
Phone
(706) 722-3401
Fax
(706) 724-6540
NPI assigned
Oct 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006258 GA Primary

Addresses

Primary practice location

811 13TH St
Suite 20
Augusta, GA 30901-2700

Mailing address

811 13TH St
Suite 20
Augusta, GA 30901-2700
Phone (706) 722-3401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111103000518 GA Practitioner - Physician Assistant 7416120696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

2511 Associates Way
Evans, GA 30809-3106
Phone (706) 722-3401

3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (706) 863-9797

811 13TH St
Suite 20
Augusta, GA 30901-2771
Phone (706) 722-3401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
79.48 of 100Reported as group
Quality
56.49
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Augusta P a CurrentSince Sep 27, 2011 Accepting new patients
Augusta Orthopedic & Sports Medicine Specialists PC CurrentSince Nov 16, 2023 Accepting new patients

Locations

811 13th St
Ste 20
Augusta, GA 30901
Phone (706) 722-3401

3650 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 863-9797

2511 Associates Way
Evans, GA 30809
Phone (706) 722-3401

150 Main St
Thomson, GA 30824
Phone (706) 595-1090

304 Jones Ave
Waynesboro, GA 30830
Phone (706) 437-0046

300 Jones Ave
Waynesboro, GA 30830
Phone (706) 702-5636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23890/brand/1/csg/1/fhir/r4
  • Direct secure messaging: judah.johnson.1@23890.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 6

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1053695957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 13TH ST",
            "address_2": "SUITE 20",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012700",
            "telephone_number": "706-722-3401",
            "fax_number": "706-724-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 13TH ST",
            "address_2": "SUITE 20",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012700",
            "telephone_number": "706-722-3401",
            "fax_number": "706-724-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JUDAH",
        "middle_name": "CHARLES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.