Michael Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1032237 Issued in CO

Practice address

289 Grayson Hwy Ste 2a
Lawrenceville, GA 30046-5726

Phone

(770) 771-5560

Fax

(678) 344-8600

NPI assigned

Oct 3, 2006

Last updated

Mar 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reagan Medical Center LLCGroup PAC ID 6507779329, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reagan Medical Center LLC

  • Family Medicine Physician
  • Suwanee, GA
  • NPI 1952316747
  Medicare reassignment Care Compare group NPD
• Cherry Creek Family Practice PLLC

  • Specialist
  • Denver, CO
  • NPI 1588758650
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1326132408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 FIVE FORKS TRICKUM RD",
            "address_2": "STE 2A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445896",
            "telephone_number": "678-344-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 GRAYSON HWY STE 2A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465726",
            "telephone_number": "770-771-5560",
            "fax_number": "678-344-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Youngfield St.",
            "address_2": "Ste #120",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "80401",
            "country_code": "US",
            "telephone_number": "720-898-9427",
            "fax_number": "303-302-0808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2696 Lawrenceville Suwanee Rd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300242535",
            "country_code": "US",
            "telephone_number": "770-771-5570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1032237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lajoya Johnson
• Lauren McKenzie Johnson, MSPA, PA-C
• Linda Johnson
• Maya Johnson
• Miatta Lassanah Johnson, PMHNP
• Michael Olton Johnson, PA
• Pooja Johnson, RBT
• Rubi Johnson
• Shaneva Johnson
• Shanika Johnson

• Medical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.