Michael Ryan Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111371 Issued in FL

Practice address

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402

Phone

(407) 580-5138

NPI assigned

Jul 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Medicare reassignment NPD
• Lake Oliver Emergency Group, LLC

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1013675016
  Medicare reassignment
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Lake Oliver Emergency Group, LLC

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1457012940

  Physician Assistant

  NPD
• Lake Oliver Emergency Group, LLC

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1548921034

  Physician Assistant

  NPD

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1063998235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084402",
            "telephone_number": "407-580-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenna Johnson
• Madelyn Mae Johnson
• Margerite Johnson, RN
• Melissa M Johnson
• Melissa Renee Johnson
• Mikeria Johnson
• Monica Henry Johnson, MSW, LCSW
• Morgan Johnson, PA-C
• Nicholas Dean Johnson, PTA
• Regina R Johnson, ARNP

• Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.