Ashley Lyn Johansson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112715 Issued in FL

Practice address

830 Executive LN Ste 150
Rockledge, FL 32955-3595

Phone

(321) 877-1800

NPI assigned

Nov 2, 2019

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

Other names 1

• Ashley Lyn Smith Former name

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

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.

• Access Endocrinology LLC

  • Medical Specialty Clinic/Center
  • Rockledge, FL
  • NPI 1427461466
  Medicare reassignment

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1457995490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 SYKES CREEK DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533066",
            "telephone_number": "321-604-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EXECUTIVE LN STE 150",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553595",
            "telephone_number": "321-877-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "ASHLEY",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-02",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "SMITH",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elisa Jennings, LMHC
• Donna S Jensen, OTR
• Lauren Mackenzie Jerdon, SLPA
• Oscar Hunt Jerkins, M.D.
• Alyssa Jimenez, LCSW
• Roxanne J Johnson-Giebink, MD
• Candace K Johnson
• Catherine Yvonne Johnson, RMCHI
• Clifford Jeron Johnson, MS
• Cynthia Johnson

• Physician Assistant in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.