Amber Renee Johnson, PAC MMS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2008026707 Issued in MO

Practice address

12255 De Paul Dr
Suite 460
Bridgeton, MO 63044-2510

Phone

(314) 770-1844

Fax

(314) 770-1843

NPI assigned

Apr 2, 2008

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 names 1

• Ms. Amber Renee Strubhar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Gateway Pediatrics, LTD

  • Pediatrics Physician
  • Chesterfield, MO
  • NPI 1639251978
  NPD

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1275706913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "SUITE 460",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-770-1844",
            "fax_number": "314-770-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "SUITE 460",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-770-1844",
            "fax_number": "314-770-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMBER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PAC MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2008026707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "STRUBHAR",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "MMS PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jermik Systems, LTD (Kursar Eyecare, Ltd.)
• John P Hoehn III MD Facs PC
• Kristy B Johnson-Herrell, MA, LPC
• Lakita A Johnson-Holmes, PHARM D
• Amarilis Johnson
• Angela B Johnson
• Aundrea Denise Johnson, PLPC
• Cherquita Johnson, LMT
• Elizabeth Johnson
• Haeley Renee Johnson

• Physician Assistant in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.