Individual provider Active NPI

Johanna Laurel Chua

  • Physician Assistant
  • Hampton, NH
National Provider Identifier
1477018604
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1451 Issued in NH
Practice address
55 High St Ste 201
Hampton, NH 03842-2213
Phone
(603) 929-2137
NPI assigned
Feb 1, 2019
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 1451 NH Primary

Addresses

Primary practice location

55 High St Ste 201
Hampton, NH 03842-2213

Mailing address

55 High St Ste 201
Hampton, NH 03842-2213
Phone (603) 929-2137

Other names 1

  • Johanna Laurel King Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20190430000353 NH Practitioner - Physician Assistant 6901148618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

330 Borthwick Ave
Suite 201
Portsmouth, NH 03801-4102
Phone (603) 436-6638

330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242

55 High St
Hampton, NH 03842-2213
Phone (603) 436-5110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1451NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group Dba Woodbury Family Practice CurrentSince Apr 1, 2019 Accepting new patients
Appledore Medical Group, Inc CurrentSince Apr 1, 2019 Accepting new patients

Locations

55 High St
Ste 201
Hampton, NH 03842
Phone (603) 436-6638

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: johanna.king@hca6.eclinicaldirectplus.com

Organizations & group practices 2

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 7

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": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1477018604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HIGH ST STE 201",
            "city": "HAMPTON",
            "state": "NH",
            "postal_code": "038422213",
            "telephone_number": "603-929-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HIGH ST STE 201",
            "city": "HAMPTON",
            "state": "NH",
            "postal_code": "038422213",
            "telephone_number": "603-929-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JOHANNA",
        "middle_name": "LAUREL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "KING",
            "middle_name": "LAUREL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, NH

Sources for this page

Verify at the official NPI Registry.