Individual provider Active NPI

Rebecca Ann Johnston, PA-C

  • Physician Assistant
  • Pinehurst, NC
National Provider Identifier
1497770671
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0100-04624 Issued in NC
Practice address
15 Regional Dr
Pinehurst, NC 28374-8850
Phone
(910) 295-9207
Fax
(910) 235-3432
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0100-04624 NC Primary
Medical Physician Assistant 363AM0700X 0110001596 VA

Addresses

Primary practice location

15 Regional Dr
Pinehurst, NC 28374-8850

Mailing address

205 Page Road
Pinehurst, NC 28374-8798
Phone (910) 295-9207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140613000071 NC Practitioner - Physician Assistant 5991718751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

15 Regional Dr
Pinehurst, NC 28374-8850
Phone (910) 295-5511

200 Pavilion Way
Southern Pines, NC 28387-4561
Phone (910) 295-5511

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

8 Regional Cir
Pinehurst, NC 28374-9796
Phone (910) 215-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0100-04624NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince May 19, 2014 Accepting new patients
Gastrointestinal Medicine Associates, PC Past Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

15 Regional Dr
Pinehurst, NC 28374
Phone (910) 255-4400

110 Dennis Dr
Sanford, NC 27330
Phone (919) 774-4511

Interoperability endpoints

  • Direct secure messaging: rebeccajohnston@phmc.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/20502/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1497770671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE ROAD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748798",
            "telephone_number": "910-295-9207",
            "fax_number": "910-235-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-295-9207",
            "fax_number": "910-235-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0100-04624",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.