Jeremy Johnson, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-09785 Issued in NC

Practice address

1130 N Church St Ste 100
Greensboro, NC 27401-1041

Phone

(336) 235-3105

Fax

(336) 375-2314

NPI assigned

Mar 25, 2014

Sex

Male

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

Enrolled in NC, WA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mw_jjohnson@sos1359.srs-direct.com

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.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Medicare reassignment Care Compare group NPD
• Murphy Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Murphy, NC
  • NPI 1053808378
  Medicare reassignment
• Murphy Hospitalist Group, PLLC

  • Hospitalist Physician
  • Murphy, NC
  • NPI 1124768544
  Medicare reassignment
• Southeastern Orthopaedic Specialists, PA

  • Orthopaedic Surgery Physician
  • Greensboro, NC
  • NPI 1790724706
  Medicare reassignment
• Southeastern Orthopaedic Specialists, PA

  • Orthopaedic Surgery Physician
  • Greensboro, NC
  • NPI 1629012935

  Physician Assistant

  NPD
• Kadlec Regional Medical Center

  • Plastic Surgery Physician
  • Richland, WA
  • NPI 1235471954
  NPD
• Kadlec Regional Medical Center

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1306263603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N CHURCH ST STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011041",
            "telephone_number": "336-235-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N CHURCH ST STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011041",
            "telephone_number": "336-235-3105",
            "fax_number": "336-375-2314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Cheverly",
            "state": "MD",
            "postal_code": "207851189",
            "country_code": "US",
            "telephone_number": "301-618-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05352",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Johnson
• Jamaya Johnson
• Janet Lee Johnson, NURSE AIDE
• Jasmine Shree Johnson
• Jena P Johnson, LCMHCA
• Jessica Carroll Johnson
• Kadaja Johnson
• Kathleen Rose Johnson, PA-C
• Kathy La Rue Johnson
• Kelly Rayburn Johnson, PA-C

• Physician Assistant in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.
• 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.

Verify at the official NPI Registry.