Jordan Kathleen Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12344 Issued in TX

Practice address

2829 Babcock Rd Ste 700
San Antonio, TX 78229-6015

Phone

(210) 804-5400

Fax

(210) 804-5633

NPI assigned

Nov 7, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1184192114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONCORD PLAZA DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166991",
            "telephone_number": "210-804-5416",
            "fax_number": "210-678-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 700",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296015",
            "telephone_number": "210-804-5400",
            "fax_number": "210-804-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3327 Research Plz Ste 404",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782355159",
            "country_code": "US",
            "telephone_number": "210-804-5400",
            "fax_number": "210-804-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Concord Plaza Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782166991",
            "country_code": "US",
            "telephone_number": "210-804-5400",
            "fax_number": "210-804-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 E Sonterra Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782584184",
            "country_code": "US",
            "telephone_number": "210-804-5400",
            "fax_number": "210-804-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Creekside Xing Ste 106",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781304093",
            "country_code": "US",
            "telephone_number": "210-804-5400",
            "fax_number": "210-804-5630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P Johnson, O.D.
• Jenia Jevelle Makelia Johnson
• Jennifer Johnson
• Jennifer Johnson
• Jerry Johnson
• Joseph E Johnson IV, MD
• Judith Irene Johnson, L.O.T., C.H.T.
• Katharine M Johnson, MD
• Katherine Alexandra Johnson
• Keith Johnson, M.D.

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.