Jennifer Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9109697 Issued in FL

Practice address

1244 S Ocean Shore Blvd
Flagler Beach, FL 32136-3703

Phone

(315) 586-2336

NPI assigned

Aug 8, 2016

Last updated

Sep 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 FL

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.

• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1407472723
  Medicare reassignment
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment
• St Vincent's Full Service Urgent Care, LLC

  • Occupational Medicine Clinic/Center
  • Jacksonville, FL
  • NPI 1750672051
  Medicare reassignment
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790
  NPD
• FL-I Medical Services LLC

  • Emergency Medicine Physician
  • Destin, FL
  • NPI 1659720654

  Physician Assistant

  NPD
• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Doral, FL
  • NPI 1154097491
  NPD (past)

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1407300460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 S OCEAN SHORE BLVD",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321363703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 S OCEAN SHORE BLVD",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321363703",
            "telephone_number": "315-586-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inc Infusion
• Integrity Behavioral & Coaching Solutions, LLC
• Katherine Jankowski
• Ronda Jo Jarvis, LCSW
• Jennifer Tipton, LLC (Connected Therapy)
• Mark Leslie Johnson, D.D.S.
• Sarah Jones
• Charlotte Jung, PHARMD
• Ellen Kincaid, BCABA
• Kemp Bradley Kirk I, D.C.

• Physician Assistant in Flagler Beach, FL
• Providers in Flagler Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.