Johna Marie Bott, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1562 Issued in KY

Practice address

2125 State St Ste 5
New Albany, IN 47150-4901

Phone

(502) 222-0028

Fax

(502) 222-0029

NPI assigned

Jul 9, 2010

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Clarion Health and Wellness LLC

  • Interventional Pain Medicine Physician
  • Hazard, KY
  • NPI 1063717080
  NPD (past)
• First Stop Urgent Care Center PSC

  • Family Medicine Physician
  • Lagrange, KY
  • NPI 1285731497

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1477865145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 NEW MOODY LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319122",
            "telephone_number": "502-222-0028",
            "fax_number": "502-222-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 STATE ST STE 5",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504901",
            "telephone_number": "502-222-0028",
            "fax_number": "502-222-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTT",
        "first_name": "JOHNA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100130280",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbott18829@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2125 State St Ste 5",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471504901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Bonar
• Kathleen M Book, PA-C
• Daniel Edward Boone, PHD
• Thomas Lee Boone, O.D.
• Carol C Borden, M.D.
• Arabella Denise Bowens, M.D
• Olivia Bower
• Rebecca Bowling, RN
• Alexandria Erin Boyd
• Jami Boyle

• Physician Assistant in New Albany, IN
• Providers in New Albany, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.