Benjamin L Johnson, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09255 Issued in TX

Practice address

2703 82ND St
Lubbock, TX 79423-1429

Phone

(806) 761-0333

Fax

(806) 782-0097

NPI assigned

Jun 30, 2008

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 TX

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

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.

• Texas Scottish Rite Hospital for Crippled Children

  • Pediatric Orthopaedic Surgery Physician
  • Dallas, TX
  • NPI 1598188948
  Medicare reassignment NPD
• CSK Medical Partners

  dba Lubbock Sports Medicine Associates

  • Specialist
  • Lubbock, TX
  • NPI 1902842404
  Medicare reassignment
• Pedi-Ortho Health Corporation

  • Pediatric Orthopaedic Surgery Physician
  • Dallas, TX
  • NPI 1265104939
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1336301480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5733 107TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248247",
            "telephone_number": "806-792-4329",
            "fax_number": "806-795-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231429",
            "telephone_number": "806-761-0333",
            "fax_number": "806-782-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "050802360",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Walter Michels; Step by Step Counseling Services
• Johnny Qubty, MD,PA
• Stephanie Johnsey, APRN
• Andrew Kincaid Johnson, D.D.S.
• Barbara Lynn Johnson, LPC
• Brian Johnson, MSNA, CRNA
• Carson Lee Johnson, M.D.
• Caytelynn May Johnson, OTR
• Christopher Don Johnson
• Courtney Johnson, PT,DPT

• Physician Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.