Gladys B Johnson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN163718 Issued in GA

Practice address

3962 Carlinswood Way
Stone Mountain, GA 30083-4776

Phone

(404) 376-2876

NPI assigned

Nov 9, 2020

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 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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blackpool LLCGroup PAC ID 2163667643, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22835/brand/1/csg/1/fhir/r4

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.

• Blackpool LLC

  • Internal Medicine Physician
  • Cumming, GA
  • NPI 1124361811
  Medicare reassignment Care Compare group NPD
• Unitedhands Health & Wellness Clinic LLC

  • Primary Care Nurse Practitioner
  • Morrow, GA
  • NPI 1366045130
  Medicare reassignment NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1407458102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3962 CARLINSWOOD WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3962 CARLINSWOOD WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834776",
            "telephone_number": "404-376-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLADYS",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN163718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jirah Creations
• Natalja Edna Johns, LMFT
• Angela A. Johnson
• Belinda Johnson
• Clifford L Johnson, EDD, LPC
• Jazmine Johnson
• Michelle Allison Johnson, REGISTERED NURSE
• Rourger Lynn Johnson, O.D.
• Samuel Johnson, M.D.
• Teresa A Johnson, MS, LPC, NCC

• Family Nurse Practitioner in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.