Carol P Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA765 Issued in ME

Practice address

1000 Rush Dr
Salida, CO 81201-9627

Phone

(719) 530-2048

Fax

(719) 530-2055

NPI assigned

Feb 24, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Merit-based Incentive Payment System (MIPS)

Final score

75.69 of 100Reported as group

Quality

71.4

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Salida Hospital District

  • Critical Access Hospital
  • Salida, CO
  • NPI 1730258971
  Medicare reassignment NPD
• Salida Hospital District

  • Internal Medicine Physician
  • Salida, CO
  • NPI 1972778272
  Medicare reassignment
• Salida Hospital District

  • Rural Health Clinic/Center
  • Buena Vista, CO
  • NPI 1427395193
  NPD
• Salida Hospital District

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Buena Vista, CO
  • NPI 1962859470
  NPD

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1205802766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W HWY 50",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812012238",
            "telephone_number": "719-530-2048",
            "fax_number": "719-530-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RUSH DR",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019627",
            "telephone_number": "719-530-2048",
            "fax_number": "719-530-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROL",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431815499",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oncology@HRRMCMedicalClinics.ssdirect.aprima.com",
            "affiliation": "Y",
            "affiliationName": "Salida Hospital District",
            "address_1": "1000 Rush Dr",
            "city": "Salida",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812019627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stefan Iverson, DO
• Karli Jacobson, PA-C
• JDL & Makl LLC
• Jenny D Filter DDS PC
• Cassidy Shanae Jimerson
• Jeanette Johnson
• Karen A. Johnson, M.D.
• Jubilant Restoration, LLC
• Whitney Elizabeth Juselius, M.D.
• Roly Creekmore Kanard, MD

• Physician Assistant in Salida, CO
• Providers in Salida, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.