Individual provider Active NPI

Adrian Elise Johnson, PA

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1306091731
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1474 Issued in CO
Practice address
830 Potomac Circle, 4TH Floor
460 Mdos/Sgop
Aurora, CO 80010
Phone
(720) 847-6055
Fax
(720) 847-6494
NPI assigned
Nov 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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 1474 CO Primary

Addresses

Primary practice location

830 Potomac Circle, 4TH Floor
460 Mdos/Sgop
Aurora, CO 80010

Mailing address

275 S. Aspen St, Stop 89; Buckley Afb
460 Mdos/Sgop
Aurora, CO 80011-9547
Phone (720) 847-6055

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flatirons Family Practice Inc PastSince Jan 9, 2011 Accepting new patients

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": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1306091731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S. ASPEN ST, STOP 89; BUCKLEY AFB",
            "address_2": "460 MDOS/SGOP",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119547",
            "telephone_number": "720-847-6055",
            "fax_number": "720-847-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 POTOMAC CIRCLE, 4TH FLOOR",
            "address_2": "460 MDOS/SGOP",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80010",
            "telephone_number": "720-847-6055",
            "fax_number": "720-847-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADRIAN",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.