Individual provider Active NPI

Lori Anne Johnson, PA

  • Medical Physician Assistant
  • Summerville, SC
National Provider Identifier
1437554425
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2171 Issued in SC
Practice address
1114 N Main St
Summerville, SC 29483-7326
Phone
(843) 212-8070
NPI assigned
Nov 3, 2014
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2171 SC Primary

Addresses

Primary practice location

1114 N Main St
Summerville, SC 29483-7326

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other identifiers 1

IdentifierTypeStateIssuer
2171OtherSCSC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150122001930 SC Practitioner - Physician Assistant 8022332030 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Nov 5, 2014 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2020 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Nov 5, 2014 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2020 Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

5325 Appian Way
Charleston, SC 29420
Phone (843) 552-0400

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

899 Island Park Dr
Ste 200
Daniel Island, SC 29492
Phone (843) 797-5050

110 Springhall Dr
Ste A
Goose Creek, SC 29445
Phone (843) 973-8503

7 S Alliance Dr
Ste 211B
Goose Creek, SC 29445
Phone (843) 553-4383

3495 Iron Horse Rd
Ladson, SC 29456
Phone (843) 793-5970

115 Executive Pkwy
Moncks Corner, SC 29461
Phone (843) 761-2815

401 N Live Oak Dr
Ste B
Moncks Corner, SC 29461
Phone (843) 761-7884

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

1114 N Main St
Summerville, SC 29483
Phone (843) 212-8034

201 Oakbrook Ln
Ste 255
Summerville, SC 29485
Phone (843) 851-2000

300 W 4th North St
Summerville, SC 29483
Phone (843) 285-7515

435 N Cedar St
Summerville, SC 29483
Phone (843) 873-1592

501 Carnes Crossing Blvd
#B
Summerville, SC 29486
Phone (843) 212-8080

507 N Laurel St
Summerville, SC 29483
Phone (843) 875-0600

809 N Cedar St
Summerville, SC 29483
Phone (843) 871-9440

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1437554425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837326",
            "telephone_number": "843-212-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LORI",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE",
            "identifier": "2171",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.