Eddie Lee Johnson Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

290824 Issued in NC

Practice address

3200 Maccorkle Ave SE
Charleston, WV 25304

Phone

(304) 388-4077

Fax

(304) 388-9852

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health New Hanover Regional Medical Center LLCGroup PAC ID 7113330168, 204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Novant Health New Hanover Regional Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Wilmington, NC
  • NPI 1750978839

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Pender Memorial Hospital Incorporated

  • Critical Access Hospital
  • Burgaw, NC
  • NPI 1053444901
  Medicare reassignment NPD
• J. Arthur Dosher Memorial Hospital

  • General Acute Care Hospital
  • Southport, NC
  • NPI 1275660342
  NPD
• Novant Health New Hanover Regional Medical Center LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Wilmington, NC
  • NPI 1932958584
  NPD
• Pender Memorial Hospital, Incorporated

  • Critical Access Hospital
  • Burgaw, NC
  • NPI 1295703130
  NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1548369929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SAUNDERS ST",
            "city": "ST ALBANS",
            "state": "WV",
            "postal_code": "25177",
            "telephone_number": "304-546-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-4077",
            "fax_number": "304-388-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EDDIE",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "54873",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "70139",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "290824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00116681",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2603380000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejohnson120498@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cathryn Johnson
• Cheyenne Storm Johnson
• Connie Johnson
• Corleeta Sharee Johnson
• Dayna Johnson
• Eric Johnson, MD
• Jacquetta Johnson
• Jada Johnson
• Jadyn Johnson
• James O Johnson, BSP

• Certified Registered Nurse Anesthetist in Charleston, WV
• Providers in Charleston, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.