Individual provider Active NPI

David Johnson, PA-C

  • Physician Assistant
  • Athens, GA
National Provider Identifier
1144662180
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006863 Issued in GA
Practice address
3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone
(706) 353-2990
Fax
(706) 353-2992
NPI assigned
Jul 18, 2013
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 006863 GA Primary

Addresses

Primary practice location

3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-4440

Other practice location 2

3320 Old Jefferson Rd Bldg 700
Athens, GA 30607-1465
Phone (706) 353-2990

Other practice location 3

1404 River Pl Ste 402
Braselton, GA 30517-5600
Phone (770) 219-8765

Other identifiers 1

IdentifierTypeStateIssuer
003137031MedicaidGA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130919000665 GA Practitioner - Physician Assistant 7618111345 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3320 Old Jefferson Rd
BLDG 700
Athens, GA 30607-1465
Phone (706) 353-2990

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
68.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Physician Assistant CurrentSince Jan 4, 2024 Accepting new patients
University Health Alliance Past Accepting new patients

Locations

3320 Old Jefferson Rd
Bldg 800
Athens, GA 30607
Phone (706) 353-2290

1404 River Pl
Ste 402
Braselton, GA 30517
Phone (770) 219-6520

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1144662180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1404 River Pl Ste 402",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-219-8765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-18",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003137031",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.