Wesley Michael Johansen

Key facts

NPI

1174904064

Entity type

Individual (NPI type 1)

Primary specialty

Anesthesiologist Assistant 367H00000X

License

7697 (GA)

Practice address

2701 N Decatur Rd
Decatur, GA 30033-5918

Phone

(404) 501-1000

NPI assigned

Jun 16, 2015

Sex

Male

Sole proprietor

No

Organizations & group practices 7

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.

• Emory Specialty Associates, LLC Anesthesiology Physician · Lagrange, GA · NPI 1407864168
  Medicare reassignment Care Compare group NPD GA
• Georgia Anesthesiologists, PC Anesthesiology Physician · Woodstock, GA · NPI 1740299197
  Medicare reassignment NPD GA
• The Emory Clinic Inc Internal Medicine Physician · Atlanta, GA · NPI 1396798229
  Medicare reassignment NPD GA
• Wellstar Medical Group, LLC Family Medicine Physician · Kennesaw, GA · NPI 1558664003
  Medicare reassignment NPD GA
• Wellstar Medical Group, LLC Multi-Specialty Clinic/Center · Marietta, GA · NPI 1275992240
  NPD
• Wellstar Medical Group, LLC Family Medicine Physician · Roswell, GA · NPI 1922405729
  NPD
• Axis Anesthesia Associates PC Anesthesiology Physician · Atlanta, GA · NPI 1184786584
  NPD (past)

Hospital & facility affiliations 1

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

• Dekalb Medical Center, Inc. General Acute Care Hospital · Decatur, GA · NPI 1093716979
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Anesthesiology Assistant

Education

Emory University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Specialty Associates, LLC (706 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Decatur Hospital Hospital · Decatur, GA · CCN 110076

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100 (apm)

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 26, 2023.

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1174904064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 Roselane St NW",
            "address_2": "Suite 750",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300606913",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "146 Bill Carruth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413749",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "677 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "WESLEY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "7697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Decatur, GA · Anesthesiologist Assistant in Georgia