Individual provider Active NPI

Skye Chen-Johnson, PA STUDENT CLINICAL

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, GA
National Provider Identifier
1528807625
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
114 Washington St SE Apt 503
Gainesville, GA 30501-3667
Phone
(253) 666-3967
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

114 Washington St SE Apt 503
Gainesville, GA 30501-3667

Mailing address

114 Washington St SE Apt 503
Gainesville, GA 30501-3667
Phone (253) 666-3967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1528807625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WASHINGTON ST SE APT 503",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013667",
            "telephone_number": "253-666-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WASHINGTON ST SE APT 503",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013667",
            "telephone_number": "253-666-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN-JOHNSON",
        "first_name": "SKYE",
        "credential": "PA STUDENT CLINICAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.