Individual provider Active NPI

Atlee Rollins Johnson III, MD

  • Urology Physician
  • Salisbury, NC
National Provider Identifier
1194709675
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
33258 Issued in NC
Practice address
911 W Henderson St
Ste 110
Salisbury, NC 28144-2736
Phone
(704) 633-9441
NPI assigned
Nov 30, 2005
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 33258 NC Primary

Addresses

Primary practice location

911 W Henderson St
Ste 110
Salisbury, NC 28144-2736

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 633-9441

Other identifiers 1

IdentifierTypeStateIssuer
8946509MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson201181@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000180 NC Practitioner - UrologyPractitioner - General Surgery 3274673967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Surgery
Education
Wake Forest University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Stone Center PLLCGroup PAC ID 2961315718, 71 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1907 S Hawthorne Rd
Winston Salem, NC 27103-3916
Phone (336) 765-6373

911 W Henderson St
Suite 120
Salisbury, NC 28144-2700
Phone (704) 637-9006

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Urology CurrentSince Sep 16, 2015 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 16, 2015 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

911 W Henderson St
Ste 110
Salisbury, NC 28144
Phone (704) 633-9441

911 W Henderson St
Ste 120
Salisbury, NC 28144
Phone (704) 637-1779

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1194709675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-633-9441",
            "fax_number": "704-637-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W HENDERSON ST",
            "address_2": "STE 110",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442736",
            "telephone_number": "704-633-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ATLEE",
        "middle_name": "ROLLINS",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "33258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8946509",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson201181@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "911 W Henderson St",
            "address_2": "STE 110",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281442736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.