NPIMap

Individual provider Active NPI

Amber Johnson, PA

  • Physician Assistant
  • El Dorado Springs, MO
National Provider Identifier
1548709256
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2017003628 Issued in MO
Practice address
309 E Hospital Rd
El Dorado Springs, MO 64744-2021
Phone
(417) 876-5851
NPI assigned
Feb 14, 2017
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2017003628 MO Primary

Addresses

Primary practice location

309 E Hospital Rd
El Dorado Springs, MO 64744-2021

Mailing address

309 E Hospital Rd
El Dorado Springs, MO 64744-2021
Phone (417) 876-5851

Other practice location 1

500 Porter Ave
Aurora, MO 65605-2365
Phone (417) 678-7888

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216001419 MO Practitioner - Physician Assistant 1759664774 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1605 Martin Springs Dr
Rolla, MO 65401-2980

309 E Hospital Rd
MC Family Medicine El Dorado SPG
El Dorado Springs, MO 64744-2021
Phone (417) 876-5851

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Physician Assistant CurrentSince Aug 21, 2022 Accepting new patients
Mercy Hospital Lebanon CurrentSince Jul 11, 2017 Accepting new patients
Mercy Hospital Cassville CurrentSince Feb 13, 2017 Accepting new patients
Mercy Hospital Aurora CurrentSince Feb 13, 2017 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 21, 2022 Accepting new patients
Mercy Clinic Springfield Communities Past Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

309 E Hospital Rd
El Dorado Springs, MO 64744
Phone (417) 876-4645

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1548709256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E HOSPITAL RD",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647442021",
            "telephone_number": "417-876-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E HOSPITAL RD",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647442021",
            "telephone_number": "417-876-5851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Porter Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "MO",
            "postal_code": "656052365",
            "country_code": "US",
            "telephone_number": "417-678-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMBER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2017003628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Springs, MO

Sources for this page

Verify at the official NPI Registry.