Individual provider Active NPI

Anita Johnson, M.D.

  • Surgical Oncology Physician
  • Woodstock, GA
National Provider Identifier
1457401630
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
53464 Issued in GA
Practice address
120 N Medical Pkwy BLDG 100
Suite 201
Woodstock, GA 30189-7062
Phone
(678) 445-0976
NPI assigned
Jan 11, 2007
Last updated
Dec 31, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 53464 GA Primary

Addresses

Primary practice location

120 N Medical Pkwy BLDG 100
Suite 201
Woodstock, GA 30189-7062

Mailing address

PO Box 5042
Canton, GA 30114-0250
Phone (678) 445-0976

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610001138 GA Practitioner - Surgical OncologyPractitioner - General Surgery 2769465772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Morehouse School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Oncology Services - Georgia, LLCGroup PAC ID 8426086901, 26 clinicians

Practice addresses (Care Compare)

5353 Reynolds St
Suite 107
Savannah, GA 31405-6089
Phone (912) 819-7630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.74 of 100Reported as group
Quality
63.81
Promoting interoperability
100
Improvement activities
40
Cost
57.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53464GAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Oncology Services - Georgia, LLC Surgical Oncology CurrentSince Jan 1, 2026 Accepting new patients

Locations

225 Candler Dr
Ste 100
Savannah, GA 31405
Phone (912) 352-1700

5353 Reynolds St
Ste 107
Savannah, GA 31405
Phone (912) 819-7630

Interoperability endpoints

  • Direct secure messaging: ajohnson145422@cityofhope.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1457401630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5042",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301140250",
            "telephone_number": "678-445-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY BLDG 100",
            "address_2": "SUITE 201",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "678-445-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANITA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "GA",
            "license": "53464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.