Active NPI
Cameron Johnson
- Physical Therapist
- Evans, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 415 Town Park Blvd
Evans, GA 30809-3487 - Phone
- (706) 868-1707
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
415 Town Park Blvd
Evans, GA 30809-3487
Mailing address
415 Town Park Blvd
Evans, GA 30809-3487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
415 Town Park Blvd
Evans, GA 30809-3487
Phone (706) 868-1707
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT017256 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Current | Accepting new patients | |
| Evans Rehabilitation Services, LLC | Physical Therapist | Current | Accepting new patients |
| Resurgens, LLC | Current | Accepting new patients |
Locations
2115 Windsor Spring Rd
Ste 2300
Augusta, GA 30906
2115 Windsor Spring Rd
Ste 23
Augusta, GA 30906
Phone (706) 793-6211
2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100
415 Town Park Blvd
Evans, GA 30809
Phone (706) 690-4372
5003 Steiner Way
Ste 2
Grovetown, GA 30813
156 Foster Dr
Ste B
McDonough, GA 30253
Phone (770) 506-4119
5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590
5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732
150 Main St
Thomson, GA 30824
Phone (706) 595-1090
Organizations & group practices 3
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.
-
dba Lake Oconee Rehabilitation and Performance Center
- Physical Therapist
- Evans, GA
- NPI 1093715773
-
dba Resurgens Orthopaedics
- Orthopaedic Surgery Physician
- Braselton, GA
- NPI 1033919790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685923200000",
"number": "1235823212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 TOWN PARK BLVD",
"city": "EVANS",
"state": "GA",
"postal_code": "308093487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 TOWN PARK BLVD",
"city": "EVANS",
"state": "GA",
"postal_code": "308093487",
"telephone_number": "706-868-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CAMERON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-05",
"last_updated": "2023-06-05",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.