Denetra Johnson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN161105 Issued in GA

Practice address

5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825

Phone

(401) 652-9787

Fax

(401) 652-9787

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment Care Compare group NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment Care Compare group NPD
• Georgia Em-I Medical Services. LLC

  • Nurse Practitioner
  • Bremen, GA
  • NPI 1851569560
  Medicare reassignment NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment NPD
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  Medicare reassignment NPD
• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  Medicare reassignment NPD
• Walker Lake Emergency Group, PC

  • Emergency Medicine Physician
  • Conyers, GA
  • NPI 1437629342
  Medicare reassignment NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  GA

  Medicare reassignment NPD
• Primary Care PLLC

  • Family Nurse Practitioner
  • Spring, TX
  • NPI 1770354763

  GA

  Medicare reassignment NPD
• Small Hospital Innovations LLC

  • Emergency Medicine Physician
  • Clewiston, FL
  • NPI 1184040560

  GA

  Medicare reassignment NPD
• Georgia Em-I Medical Services PC

  • Physician Assistant
  • Chatsworth, GA
  • NPI 1699113357
  NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005
  NPD

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1205207388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5095 MOUNT ZION PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 MOUNT ZION PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817825",
            "telephone_number": "401-652-9787",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENETRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865978",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN161105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN161105",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• C J Johnson, PSYD
• Candace J Johnson, M.D.
• Candice Johnson
• Charla V Johnson, PA-C
• Courtney Nicole Johnson, D.P.T.
• Jamia Joy Johnson
• Jasmine Johnson, DPT
• Jessica Charles Johnson, BCBA
• Kennedy Johnson
• Michiko Wanateshe Johnson

• Family Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.