Individual provider Active NPI

Daniel Alan Johnson, PA-C

  • Physician Assistant
  • Conyers, GA
National Provider Identifier
1336967249
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12501 Issued in GA
Practice address
1301 Sigman Rd NE Ste 125
Conyers, GA 30012-3820
Phone
(678) 413-6276
Fax
(678) 413-6277
NPI assigned
Sep 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 12501 GA Primary

Addresses

Primary practice location

1301 Sigman Rd NE Ste 125
Conyers, GA 30012-3820

Mailing address

900 Circle 75 Pkwy SE Ste 1700
Atlanta, GA 30339-3087
Phone (678) 996-7230

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241209001227 GA Practitioner - Physician Assistant 4880120237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

1301 Sigman Rd NE
Suite 125
Conyers, GA 30012-3820
Phone (678) 413-6276

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812

8225 Mall Pkwy
Suite 110
Lithonia, GA 30038-6996
Phone (678) 723-6434

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC CurrentSince Nov 4, 2024 Accepting new patients
Orthoatlanta, LLC CurrentSince Nov 4, 2024 Accepting new patients

Locations

900 Circle 75 Pkwy SE
Ste 1700
Atlanta, GA 30339
Phone (770) 953-6929

1301 Sigman Rd NE
Ste 125
Conyers, GA 30012
Phone (678) 413-6276

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1336967249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE STE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393087",
            "telephone_number": "678-996-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE STE 125",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123820",
            "telephone_number": "678-413-6276",
            "fax_number": "678-413-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIEL",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.