Angela Dawn Johnson, APRN
Individual provider Active NPI Family Nurse Practitioner · Folkston, GA
NPI 1487858650 · NPPES record last updated Sep 11, 2015
Key facts
- NPI
- 1487858650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN113824NP (GA)
- Practice address
- 2383 Third St
Folkston, GA 31537-8917 - Phone
- (912) 496-4478
- Fax
- (912) 496-1139
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amelia Medical Services LLC
Practice addresses (Care Compare)
3435 2ND St S
Folkston, GA 31537-8447
Phone (912) 496-0041
Hospital & facility affiliations
- Memorial Satilla Health
- Southeast Georgia Health System -- Camden Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080604000409 | GA | Practitioner - Nurse Practitioner | 1052481959 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN113824NP | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Current |
Accepting new patients | |
| Amelia Medical Services, LLC | Current |
Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current |
Accepting new patients | |
| Amelia Medical Services, LLC | Current |
Accepting new patients | |
| Peach Care LLC | Past |
Accepting new patients |
Locations
96279 Brady Point Rd
Fernandina Beach, FL 32034
Phone (904) 321-0088
2383 Third St
Folkston, GA 31537
Phone (912) 496-1155
3435 Second St S
Folkston, GA 31537
Phone (912) 467-0041
201 Lakeshore Pt
Ste B
Saint Marys, GA 31558
Phone (912) 729-6821
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN113824NP | GA | Yes |
Addresses
Primary practice location
2383 Third St
Folkston, GA 31537-8917
Mailing address
2383 Third St
Folkston, GA 31537-8917
Phone (912) 496-4478
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167741799D | Medicaid | GA |
Other providers in Folkston, GA
- Hari Gnanasekeram, PC
- Heather Harris
- Omer Higginbotham Jr.
- Miranda B Jennings
- John N Winnie MD; PC
- Joseph Andrew Jones
- Lindsay M Joseph
- Jennifer Nicole Kelley
- Miranda King
- L.I.F.E. Counseling Services
All providers in Folkston, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.