Mary Alice Johnson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN120782 Issued in GA

Practice address

425 W 3Rd Ave
Lower Level
Albany, GA 31701-1941

Phone

(229) 312-7050

Fax

(229) 312-7055

NPI assigned

Oct 31, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Phoebe Putney Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Pelham, GA
  • NPI 1821239765
  NPD (past)
• Phoebe Putney Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Camilla, GA
  • NPI 1821293788
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1275619108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 3RD AVE",
            "address_2": "STE 101",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011985",
            "telephone_number": "229-312-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE",
            "address_2": "LOWER LEVEL",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011941",
            "telephone_number": "229-312-7050",
            "fax_number": "229-312-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "RN120782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN120782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Falan Collier Johnson, PHARMD
• Heather Constance Johnson, FNP
• Jan Ray Johnson, R.PH.
• Javier Damonte Johnson, D.D.S
• Kyle W Johnson, DO
• Minnie Johnson
• Nancy G. Johnson, OD
• Nicole Johnson, P.T.A.
• Robert Colby Johnson, AA
• Robyn Mann Johnson, M.D.

• Family Nurse Practitioner in Albany, GA
• Providers in Albany, 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 Nov 15, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.