Individual provider Active NPI

Yolanda Oglesby Johnson, MD

  • Pediatrics Physician
  • Lawrenceville, GA
National Provider Identifier
1215918388
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
070469 Issued in GA
Practice address
595 Hurricane Shoals Road
Suite 300
Lawrenceville, GA 30046
Phone
(770) 995-0823
Fax
(770) 995-7018
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 070469 GA Primary

Addresses

Primary practice location

595 Hurricane Shoals Road
Suite 300
Lawrenceville, GA 30046

Mailing address

595 Hurricane Shoals Road
Suite 300
Lawrenceville, GA 30046
Phone (770) 995-0823

Other identifiers 3

IdentifierTypeStateIssuer
89132PWMedicaidNC
1215918388MedicaidNC
132PWOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
070469GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Pediatrics & Adolescent Medicine Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yolanda.johnson.1@14859.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14859/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1215918388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS ROAD",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS ROAD",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YOLANDA",
        "middle_name": "OGLESBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "070469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132PW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215918388",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "132PW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.