Cheryl L Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104060 Issued in FL

Practice address

943 S Beneva Rd
Suite 306
Sarasota, FL 34232-2476

Phone

(941) 362-8644

Fax

(941) 954-4440

NPI assigned

Jan 14, 2009

Last updated

Jan 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cheryl L Deacon Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment Care Compare group NPD
• Global Physician Network LLC Series II

  • Emergency Medicine Physician
  • Sarasota, FL
  • NPI 1821518028
  Medicare reassignment
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284
  Medicare reassignment
• Gulf Coast Emergency Physicians PA

  • Emergency Medicine Physician
  • Port Charlotte, FL
  • NPI 1518989318
  NPD (past)

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

• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital - Venice

  • General Acute Care Hospital
  • North Venice, FL
  • NPI 1013534445
  Care Compare affiliation
• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1134366016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 S BENEVA RD",
            "address_2": "SUITE 306",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322476",
            "telephone_number": "941-362-8644",
            "fax_number": "941-954-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393509",
            "country_code": "US",
            "telephone_number": "941-917-4896",
            "fax_number": "941-917-6884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHERYL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA9104060",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "Y00LF",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "DEACON",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooklyn Johnson
• Cameron Johnson, DMD
• Carrie Johnson, APRN
• Casey Daniel Edward Johnson, DO
• Catherine E. Johnson, A.P.
• Clifford David Johnson II
• Dennis Johnson, DDS
• Elizabeth Ashley Johnson, P.A.-C
• James Henry Johnson Jr., MD
• Jeremy Johnson, PT, DPT

• Medical Physician Assistant in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.

Verify at the official NPI Registry.