Individual provider Active NPI

Lauren Marie Johnson, PA-C

  • Physician Assistant
  • Pelham, AL
National Provider Identifier
1104376003
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1131 Issued in AL
Practice address
2508 Pelham Pkwy
Pelham, AL 35124-1321
Phone
(205) 664-0880
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1131 AL Primary

Addresses

Primary practice location

2508 Pelham Pkwy
Pelham, AL 35124-1321

Mailing address

2508 Pelham Pkwy
Pelham, AL 35124-1321
Phone (205) 664-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3220 5TH Ave S
Suite 100
Birmingham, AL 35222-2309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1131ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cahaba Family Medicine, P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1104376003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 PELHAM PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241321",
            "telephone_number": "205-664-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 PELHAM PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241321",
            "telephone_number": "205-664-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

Verify at the official NPI Registry.