Lavarous Antwon Johnson, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

401 W Kennedy Blvd
Tampa, FL 33606-1450

Phone

(757) 528-7563

NPI assigned

Dec 22, 2021

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

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tampa Family Health Centers IncGroup PAC ID 1254243769, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1256.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa Family Health Centers Inc

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1356347413
  Medicare reassignment Care Compare group NPD (past)
• Memon Health Associates, LLC

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1891164398
  Medicare reassignment
• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1063718013
  Medicare reassignment
• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Punta Gorda, FL
  • NPI 1174336119
  NPD
• Synergic Healthcare Solutions LLC

  • General Practice Physician
  • Wesley Chapel, FL
  • NPI 1194198382
  NPD
• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Lutz, FL
  • NPI 1558135814
  NPD
• Tampa Family Health Centers, Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1831769579
  NPD
• Tampa Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1891251336
  NPD
• American Lung and Sleep Disorders Consultants PA

  • Pulmonary Disease Physician
  • Pinellas Park, FL
  • NPI 1467464990
  NPD (past)
• Tampa Family Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1104866870
  NPD (past)
• Tampa Family Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Lutz, FL
  • NPI 1194392019
  NPD (past)
• Tampa Family Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1316942840
  NPD (past)

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1073273660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061450",
            "telephone_number": "757-528-7563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6223 66th St N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337815025",
            "country_code": "US",
            "telephone_number": "727-528-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAVAROUS",
        "middle_name": "ANTWON",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-22",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Erin Johnson
• Kristopher Johnson
• Lanee Riley Johnson, M.D.
• Lativia Deanna Johnson
• Laura J Johnson, APRN
• Madilyn Johnson
• Madison Johnson
• Malachi Johnson
• Marlin Johnson
• Matthew S Johnson, DDS MSD

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.