Lionel Terry Johnson, OPERATIONS

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

00315 Issued in GA

Practice address

5825 Glenridge Dr Ste 2-212
Atlanta, GA 30328-5394

Phone

(678) 939-2749

Fax

(404) 256-2627

NPI assigned

Nov 9, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1573257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1144865528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 GLENRIDGE DR STE 2-214",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285394",
            "telephone_number": "678-939-2749",
            "fax_number": "404-256-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 GLENRIDGE DR STE 2-212",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285394",
            "telephone_number": "678-939-2749",
            "fax_number": "404-256-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LIONEL",
        "middle_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "OPERATIONS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-09",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "00315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Atlanta",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5825 Glenridge Dr Ste 2-212",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303285394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauris Wallace Johnson, DMD
• Lauryn Denise Johnson
• Lawana R Johnson, NP
• Lindsay Danielle Johnson, NP
• Lingeela La'Isa Johnson, PHD
• Lisa Johnson
• Lydia Johnson
• Lynsey A. Johnson
• Makaylia State University Johnson
• Mantique Johnson, D.D.S

• Pain Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.