Individual provider Active NPI

Sharon T Johnson, P.T.A, R.N,

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1104068840
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20287 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Mar 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN185304 GA
Physical Therapy Assistant 225200000X PTA1521 SC
Physical Therapy Assistant 225200000X PTA002269 GA
Family Nurse Practitioner 363LF0000X RN185304 GA
Family Nurse Practitioner 363LF0000X 20287 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Other practice location 1

6849 Peachtree Dunwoody Rd NE
Suite 102
Atlanta, GA 30328-1610
Phone (678) 587-9922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20171101002328 SC Practitioner - Nurse Practitioner 1850667148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

1053 Ctr St
West Columbia, SC 29169-6749
Phone (800) 491-0909

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

21 Edwards St
Sumter, SC 29150-4808
Phone (800) 491-0909

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN185304GAMDCritical Care Medicine Registered Nurse
PTA002269GAMDPhysical Therapy Assistant
PTA1521SCMDPhysical Therapy Assistant
20287SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Aug 29, 2017 Accepting new patients
SC House Calls Inc CurrentSince Aug 29, 2017 Accepting new patients

Locations

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: sharon.johnson.1@7602.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1104068840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6849 Peachtree Dunwoody Rd NE",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303281610",
            "country_code": "US",
            "telephone_number": "678-587-9922",
            "fax_number": "678-587-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARON",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "P.T.A, R.N,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-26",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "RN185304",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "PTA1521",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN185304",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.