Individual provider Active NPI

Brook A. Johnson, PA

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1154354223
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13224 Issued in GA
Practice address
910 Blackford St
Chattanooga, TN 37403-1405
Phone
(423) 778-6011
Fax
(865) 539-8008
NPI assigned
Jul 9, 2006
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0000001176 TN
Physician Assistant 363A00000X 66852 CA
Physician Assistant 363A00000X 13224 GA Primary

Addresses

Primary practice location

910 Blackford St
Chattanooga, TN 37403-1405

Mailing address

PO Box 634811
Cincinnati, OH 45263-4811

Other practice location 1

1001 Johnson Ferry Rd
Atlanta, GA 30342-1605
Phone (404) 785-2273

Other identifiers 3

IdentifierTypeStateIssuer
4104205OtherTNBLUE CROSS
593101463BMedicaidGA
009938377MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050125000389 TN Practitioner - Physician Assistant 1254381551 Reassigns benefits to 2 organizations
I20250825003561 CA Practitioner - Physician Assistant 1254381551 Reassigns benefits to 1 organization
I20250925002301 GA Practitioner - Physician Assistant 1254381551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

403 McBrien Rd
East Ridge, TN 37412-3223
Phone (423) 894-3589

455 Chickamauga Dr
Suite 104
Dayton, TN 37321-4286
Phone (423) 570-0252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0000001176TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Health Centers CurrentSince Aug 18, 2025 Accepting new patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince Jun 1, 2025 Accepting new patients
Golden Valley Health Center CurrentSince Aug 18, 2025 Accepting new patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince Jun 1, 2025 Accepting new patients
Emergency Coverage Services, PC Physician Assistant Past Accepting new patients
Golden Valley Health Center Past Accepting new patients

Locations

1910 Customer Care Way
Atwater, CA 95301
Phone (209) 384-6488

1405 California Ave
Dos Palos, CA 93620
Phone (209) 392-2111

13161 Jefferson St
Le Grand, CA 95333
Phone (209) 389-1900

821 Texas Ave
Los Banos, CA 93635
Phone (209) 385-5481

250 Northgate Dr
Manteca, CA 95336
Phone (209) 381-7120

3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104

797 W Childs Ave
Merced, CA 95341
Phone (209) 383-5871

847 W Childs Ave
Merced, CA 95341
Phone (209) 383-7441

1114 6th St
Modesto, CA 95354
Phone (209) 576-2845

1121 Hammond St
Modesto, CA 95351
Phone (209) 384-6488

1500 Florida Ave
Modesto, CA 95350
Phone (209) 571-5071

2101 Tenaya Dr
Modesto, CA 95354
Phone (209) 527-0080

637 Merced St
Newman, CA 95360
Phone (209) 862-0270

200 C St
Patterson, CA 95363
Phone (209) 892-6307

9235 E Broadway St
Planada, CA 95365
Phone (209) 382-0253

4150 Patterson Rd
Riverbank, CA 95367
Phone (209) 628-4435

1200 W Main St
Turlock, CA 95380
Phone (209) 668-5388

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1154354223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634811",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-6011",
            "fax_number": "865-539-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421605",
            "country_code": "US",
            "telephone_number": "404-785-2273",
            "fax_number": "404-785-9168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BROOK",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000001176",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66852",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4104205",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "593101463B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009938377",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.