Active NPI
Valerie Johnson, PA
- Physician Assistant
- Beaumont, TX
National Provider Identifier
1114059516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02197
- Practice address
- 6450 Folsom Dr
Beaumont, TX 77706-7269 - Phone
- (409) 835-0524
- Fax
- (409) 923-1293
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02197 | TX | Primary |
Addresses
Primary practice location
6450 Folsom Dr
Beaumont, TX 77706-7269
Mailing address
6450 Folsom Dr
Beaumont, TX 77706-7269
Phone (409) 835-0524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02197 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187222400000",
"number": "1114059516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6450 FOLSOM DR",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777067269",
"telephone_number": "409-835-0524",
"fax_number": "409-923-1293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6450 FOLSOM DR",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777067269",
"telephone_number": "409-835-0524",
"fax_number": "409-923-1293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "VALERIE",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.