Individual provider Active NPI

Andee Blair Johnson, PA-C

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1407459654
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.1702 Issued in AL
Practice address
201 Governors Dr SW FL 1
Huntsville, AL 35801-5171
Phone
(256) 533-1600
Fax
(256) 539-0856
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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 PA.1702 AL Primary

Addresses

Primary practice location

201 Governors Dr SW FL 1
Huntsville, AL 35801-5171

Mailing address

201 Governors Dr SW FL 1
Huntsville, AL 35801-5171
Phone (256) 533-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20201202002942 AL Practitioner - Physician Assistant 9234540873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Hospital Spine and Neuro CenterGroup PAC ID 7214221464, 33 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421

201 Governors Dr SW
FL 1
Huntsville, AL 35801-5171
Phone (256) 533-1600

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.1702ALMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: andee.johnson@sanc-al.direct.office.nextgen.com

Organizations & group practices 1

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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1407459654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW FL 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015171",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW FL 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015171",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDEE",
        "middle_name": "BLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.