Maureen Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2219 Issued in GA

Practice address

1401 Tift Ave N
Suite B
Tifton, GA 31794-3585

Phone

(229) 382-5554

Fax

(229) 382-0530

NPI assigned

Nov 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Coastal Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Brunswick, GA
  • NPI 1609298751
  NPD
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  NPD (past)
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD (past)

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1598042616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7258",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317937258",
            "telephone_number": "954-270-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 TIFT AVE N",
            "address_2": "SUITE B",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943585",
            "telephone_number": "229-382-5554",
            "fax_number": "229-382-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MAUREEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "2219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Levette Johnson-Barnes, FNP-C
• Nettie Johnson-McAllister, FNP-C
• Brian James Johnson, RPH
• Carl David Johnson III, MD
• Joel M Johnson, MD
• Nikkia F. Johnson, MD
• Rebecca Suzanna Johnson
• Yolonda Tanika Johnson
• Holly Elizabeth Jones, LPC
• Paige Huston Jones, NP

• Medical Physician Assistant in Tifton, GA
• Providers in Tifton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.