Betty Lynne Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110840360 Issued in VA

Practice address

Main Street
Campbell University
Buies Creek, NC 27506

Phone

(910) 893-1779

Fax

(910) 814-5567

NPI assigned

Jan 31, 2006

Last updated

Sep 30, 2011By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Coats Medical Clinic, PA

  • Specialist
  • Coats, NC
  • NPI 1366428195
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1093786675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 WINDING OAK WAY",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204089",
            "telephone_number": "919-934-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIN STREET",
            "address_2": "CAMPBELL UNIVERSITY",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "27506",
            "telephone_number": "910-893-1779",
            "fax_number": "910-814-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BETTY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Allen Fenn, PA
• Shelia Glenn, RN
• Abigail R Harrison, MS, LAT, ATC
• Alissa Hennen
• Angela C. Holland, R.N.
• Matthew John Kesic, PHD, PA-S2
• Dawn Alicia Kuch
• Jessica Lail Libicer, PA-S
• Nichole A. Lilly
• Lobsang Lobsang

• Medical Physician Assistant in Buies Creek, NC
• Providers in Buies Creek, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.