NPIMap

Individual provider Active NPI

Vincent Bernard Johnson, APRN

  • Family Nurse Practitioner
  • Orangeburg, SC
National Provider Identifier
1053717082
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19182 Issued in SC
Practice address
3310 Magnolia St
Orangeburg, SC 29115-1466
Phone
(803) 531-6900
NPI assigned
Nov 19, 2014
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19182 SC Primary

Addresses

Primary practice location

3310 Magnolia St
Orangeburg, SC 29115-1466

Mailing address

3310 Magnolia St
Orangeburg, SC 29115-1466
Phone (803) 531-6900

Other identifiers 1

IdentifierTypeStateIssuer
NP3041MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150128000714 SC Practitioner - Nurse Practitioner 9638493356 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies South Carolina LLCGroup PAC ID 1355705070, 16 clinicians
Family Health Centers, Inc.Group PAC ID 2860305075, 25 clinicians

Practice addresses (Care Compare)

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone (469) 340-1366

3310 Magnolia St
Orangeburg, SC 29115-1466

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.83
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Family Health Centers, Inc CurrentSince Apr 24, 2023 Accepting new patients
App of South Carolina Ed PLLC CurrentSince Oct 31, 2017 Accepting new patients
Family Health Centers, Inc CurrentSince Apr 24, 2023 Accepting new patients
Sound Physicians Emergency Medicine of South Carolina LLC CurrentSince Sep 1, 2021 Accepting new patients
Ies South Carolina LLC CurrentSince Aug 6, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 11, 2018 Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

899 Island Park Dr
Ste 200
Daniel Island, SC 29492
Phone (843) 797-5050

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

922 Holly St
Holly Hill, SC 29059
Phone (803) 496-7174

3310 Magnolia St
Orangeburg, SC 29115
Phone (803) 531-6900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFEFCD
  • Direct secure messaging: vincent.johnson@ppcp1.eclinicaldirectplus.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1053717082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291151466",
            "telephone_number": "803-531-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291151466",
            "telephone_number": "803-531-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VINCENT",
        "middle_name": "BERNARD",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3041",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.