Active NPI
Jessica Marie Johnson, PA-C
- Physician Assistant
- Jacksonville, FL
National Provider Identifier
1124540588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5927 Old Timuquana Rd
Jacksonville, FL 32210-7889 - Phone
- (844) 937-4731
- NPI assigned
- Jul 7, 2017
- 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 | Primary |
Addresses
Primary practice location
5927 Old Timuquana Rd
Jacksonville, FL 32210-7889
Mailing address
1244 S Ocean Shore Blvd
Flagler Beach, FL 32136-3703
Phone (904) 556-6152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
113 Main St
Akutan, AK 99553-0113
Phone (907) 698-2208
2105 Main St
Adak, AK 99546-2105
Phone (907) 592-8383
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspire to Rise, Inc. | Current | Accepting new patients |
Locations
5927 Old Timuquana Rd
Jacksonville, FL 32210
Phone (844) 937-4731
Interoperability endpoints
- jessica.johnson.2@8967.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Occupational Medicine Clinic/Center
- Jacksonville, FL
- NPI 1750672051
-
- Case Management Agency
- Jacksonville, FL
- NPI 1679056857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1124540588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1244 S OCEAN SHORE BLVD",
"city": "FLAGLER BEACH",
"state": "FL",
"postal_code": "321363703",
"telephone_number": "904-556-6152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5927 OLD TIMUQUANA RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322107889",
"telephone_number": "844-937-4731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-07",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.