Individual provider Active NPI

Richard Alexander Johnson, PA-C

  • Medical Physician Assistant
  • Birmingham, AL
National Provider Identifier
1548975907
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.2117 Issued in AL
Practice address
619 19TH Street South
West Pavilion 9TH Floor; Room # P902
Birmingham, AL 35233
Phone
(205) 975-0511
NPI assigned
Jan 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.2117 AL Primary

Addresses

Primary practice location

619 19TH Street South
West Pavilion 9TH Floor; Room # P902
Birmingham, AL 35233

Mailing address

619 19TH Street South
West Pavilion 9TH Floor; Room # P902
Birmingham, AL 35233
Phone (205) 975-0511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20230412001603 AL Practitioner - Physician Assistant 5496120032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2117ALMDClinical Psychologist
PA.2117ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Apr 1, 2023 Accepting new patients
University of Alabama Health Services Foundation, PC CurrentSince Apr 1, 2023 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1802 6th Ave S
Birmingham, AL 35233
Phone (205) 934-5105

619 19th St S
Fl 9
Birmingham, AL 35233
Phone (205) 975-0511

619 19th St S
Birmingham, AL 35249

Interoperability endpoints

  • Direct secure messaging: rajohnson@direct.uabmedicine.org

Organizations & group practices 2

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 2

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1548975907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "address_2": "WEST PAVILION 9TH FLOOR; ROOM # P902",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-975-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "address_2": "WEST PAVILION 9TH FLOOR; ROOM # P902",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-975-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "ALEXANDER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.2117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.