Active NPI
Amanda Jane Johnson, PA-C
- Surgical Physician Assistant
- New Bern, NC
National Provider Identifier
1396842837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 103524
- Practice address
- 705 Newman Rd
New Bern, NC 28562-5239 - Phone
- (252) 633-2712
- NPI assigned
- Sep 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 103524 | NC | |
| Surgical Physician Assistant | 363AS0400X | 103524 | NC | Primary |
Addresses
Primary practice location
705 Newman Rd
New Bern, NC 28562-5239
Mailing address
705 Newman Rd
New Bern, NC 28562-5239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103524 | NC | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1396842837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 NEWMAN RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285625239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 NEWMAN RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285625239",
"telephone_number": "252-633-2712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMANDA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-19",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NC",
"license": "103524",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NC",
"license": "103524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.