Individual provider Active NPI

Ray Edward Johnson, M.D.

  • Interventional Cardiology Physician
  • Augusta, GA
National Provider Identifier
1124046545
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
27647 Issued in GA
Practice address
1348 Walton Way
Suite 5100
Augusta, GA 30901-5104
Phone
(706) 724-8611
Fax
(706) 724-6202
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 017835 GA
Interventional Cardiology Physician 207RI0011X 27647 GA Primary

Addresses

Primary practice location

1348 Walton Way
Suite 5100
Augusta, GA 30901-5104

Mailing address

1348 Walton Way
Suite 5100
Augusta, GA 30901-5104
Phone (706) 724-8611

Other identifiers 6

IdentifierTypeStateIssuer
00222384AMedicaidGA
2089836OtherGAAETNA HMO
2671375-002OtherGACIGNA
4115000OtherGAAETNA PPO
G17835MedicaidSC
237923OtherGABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000634 GA Practitioner - Cardiovascular Disease (Cardiology) 1456366392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Mississippi School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

95 Collier Rd NW
Suite 2055
Atlanta, GA 30309-1721
Phone (404) 605-5699

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017835GAMDCardiovascular Disease Physician
27647GAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Cardiology Associates LLC Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
University Cardiology Associates LLC Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Sep 1, 2023 Accepting new patients
Cardiovascular Associates of Augusta, PA Cardiovascular Disease PastSince Jan 1, 1997 Accepting new patients

Locations

95 Collier Rd NW
Ste 2055
Atlanta, GA 30309
Phone (404) 355-9515

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1348 Walton Way
Ste 5100
Augusta, GA 30901
Phone (706) 724-8611

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1124046545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "SUITE 5100",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-724-8611",
            "fax_number": "706-724-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "SUITE 5100",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-724-8611",
            "fax_number": "706-724-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RAY",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "017835",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "27647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00222384A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2089836",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2671375-002",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4115000",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G17835",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "237923",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.