Casey Benjamin Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2291 Issued in TN

Practice address

9430 Park West Blvd Ste 310
Knoxville, TN 37923-4203

Phone

(865) 690-5263

Fax

(865) 588-3740

NPI assigned

Feb 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

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.

• Premier Surgical Associates, PLLC

  • Prosthetic/Orthotic Supplier
  • Knoxville, TN
  • NPI 1285806919
  NPD (past)

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1093054033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5675",
            "fax_number": "865-584-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 PARK WEST BLVD STE 310",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234203",
            "telephone_number": "865-690-5263",
            "fax_number": "865-588-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CASEY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2291",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "PA2291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000510",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Renee Johnson
• Benjamin Johnson, DMD
• Benjamin W Johnson Jr., M.D.
• Byran Johnson, H.S.
• Camryn Johnson, M.S. CCC-SLP
• Charlene Arnold Johnson
• Charlotte M Johnson
• Chelsea Noel Johnson
• Christine L Johnson, CRNA
• Courtney Johnson

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.