Crystal Shantae Johnson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0914437 Issued in GA

Practice address

3903 S Cobb Dr SE
Suite 225
Smyrna, GA 30080-8504

Phone

(770) 434-1904

Fax

(770) 434-1304

NPI assigned

Nov 4, 2014

Last updated

Jun 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.774191

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.

• Genesis Healthcare Associates PC

  • General Practice Physician
  • Smyrna, GA
  • NPI 1154453736
  NPD (past)

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1326443284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WATERBROOK TER",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762933",
            "telephone_number": "404-281-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE",
            "address_2": "SUITE 225",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808504",
            "telephone_number": "770-434-1904",
            "fax_number": "770-434-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRYSTAL",
        "middle_name": "SHANTAE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F0914437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bequandra Johnson
• Brittany Johnson, PT, DPT
• Carlos R Johnson, DPT
• Charleen S Johnson, M.S., CCC-SLP
• Christian Marie Johnson, D.D.S.
• Gabrielle Johnson
• Gabrielle Sade Johnson
• Kay Yetunde Johnson, NP
• Lindsey Johnson, LCSW
• Roy H Johnson, D.D.S

• Family Nurse Practitioner in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.