Individual provider Active NPI

Vicky Lenette Johnson, FNP-C

  • Primary Care Nurse Practitioner
  • Lithonia, GA
National Provider Identifier
1396116034
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN201739 Issued in GA
Practice address
2491 Panola Rd
Lithonia, GA 30058-4831
Phone
(678) 205-4999
NPI assigned
Oct 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN201739 GA Primary

Addresses

Primary practice location

2491 Panola Rd
Lithonia, GA 30058-4831

Mailing address

1315 Wild Rose Dr SE
Conyers, GA 30013-7444
Phone (678) 852-5475

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
I20160920001894 GA Practitioner - Nurse Practitioner 1658661582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

14779 Brown Bridge Rd
Covington, GA 30016-4127
Phone (770) 788-7777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation CurrentSince Sep 30, 2017 Accepting new patients
Georgia Family Care, LLC PastSince Jun 1, 2005 Accepting new patients
Piedmont Providers LLC PastSince Dec 10, 2018 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEFBDA

Organizations & group practices 3

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": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1396116034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 WILD ROSE DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300137444",
            "telephone_number": "678-852-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2491 PANOLA RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584831",
            "telephone_number": "678-205-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICKY",
        "middle_name": "LENETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN201739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.