Miatta Lassanah Johnson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN259964 Issued in GA

Practice address

1557 Buford Drive
P.O.Box 492994
Lawrenceville, GA 30043

Phone

(470) 305-3899

NPI assigned

Nov 19, 2024

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• United Psychology Center, LLC

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1063704542
  Medicare reassignment NPD

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1184449878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 BUFORD DRIVE",
            "address_2": "P.O.BOX 492994",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 BUFORD DRIVE",
            "address_2": "P.O.BOX 492994",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "470-305-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIATTA",
        "middle_name": "LASSANAH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN259964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacreatia Roxanne Johnson, RN
• Lajoya Johnson
• Lauren McKenzie Johnson, MSPA, PA-C
• Linda Johnson
• Maya Johnson
• Michael Johnson, PA-C
• Michael Olton Johnson, PA
• Pooja Johnson, RBT
• Rubi Johnson
• Shaneva Johnson

• Psychiatric/Mental Health Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.