Individual provider Active NPI

Isabel Miles Johnson

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1295549111
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3021 Reidville Rd
Spartanburg, SC 29301-5643
Phone
(864) 576-9201
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X SC Primary

Addresses

Primary practice location

3021 Reidville Rd
Spartanburg, SC 29301-5643

Mailing address

330 Harrison Rd
Roebuck, SC 29376-3614
Phone (864) 706-8146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20251115000095 SC Practitioner - Physician Assistant 4082105267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3021 Reidville Rd
Spartanburg, SC 29301-5643

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5899SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physicians of Spartanburg, PC CurrentSince Jul 26, 2025 Accepting new patients

Locations

3021 Reidville Rd
Spartanburg, SC 29301
Phone (864) 576-9201

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAJFAA

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1295549111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HARRISON RD",
            "city": "ROEBUCK",
            "state": "SC",
            "postal_code": "293763614",
            "telephone_number": "864-706-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015643",
            "telephone_number": "864-576-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ISABEL",
        "middle_name": "MILES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.