Individual provider Active NPI

Robert Edward Johnson, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1609969674
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02065 Issued in NC
Practice address
2280 US Highway 70 SE
Hickory, NC 28602-5164
Phone
(828) 267-1201
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9102838 FL
Medical Physician Assistant 363AM0700X 0010-02065 NC
Physician Assistant 363A00000X 0010-02065 NC Primary
Medical Physician Assistant 363AM0700X 005331 GA
Physician Assistant 363A00000X 9102838 FL

Addresses

Primary practice location

2280 US Highway 70 SE
Hickory, NC 28602-5164

Mailing address

308 Praley St NW
Valdese, NC 28690-2328
Phone (321) 297-7115

Other practice location 1

126 S Nova Rd
Ormond Beach, FL 32174-6115
Phone (386) 673-9949

Other practice location 2

1860 Renzulli Rd
New Smyrna Beach, FL 32168-1726
Phone (386) 663-3061

Other practice location 3

800 N Stone St
Deland, FL 32720-3256
Phone (386) 261-8608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040909000477 FL Practitioner - Physician Assistant 0042286197 Reassigns benefits to 2 organizations
I20091125000545 NC Practitioner - Physician Assistant 0042286197 Reassigns benefits to 3 organizations
I20150630000983 NY Practitioner - Physician Assistant 0042286197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Urgent Care and Family Care of WNC PLLCGroup PAC ID 2567713332, 75 clinicians
Fastmed PCGroup PAC ID 9830540558, 174 clinicians
Blue Ridge Healthcare Medical Group IncGroup PAC ID 9436159712, 222 clinicians
Ormond Medical ArtsGroup PAC ID 1254222565, 38 clinicians

Practice addresses (Care Compare)

10102 Johnston Rd
Charlotte, NC 28210-8203
Phone (704) 247-6578

1361 Klumac Rd
Salisbury, NC 28147-9086
Phone (704) 603-1175

160 Hendersonville Rd
Asheville, NC 28803-2680
Phone (828) 210-2835

1903 Addison Ave
Wilkesboro, NC 28697-2262
Phone (336) 667-2710

210 Turnersburg Hwy
Suite C
Statesville, NC 28625-2797
Phone (704) 924-4740

295 Williamson Rd
Suite a
Mooresville, NC 28117-8269
Phone (980) 444-2003

314 Blowing Rock Blvd
Lenoir, NC 28645-4406
Phone (828) 237-2287

440 Tyvola Rd
Charlotte, NC 28217-3560
Phone (704) 228-1784

511 Smokey Park Hwy
Candler, NC 28715-8613
Phone (828) 365-1088

695 W Fleming Dr
Morganton, NC 28655-4450
Phone (828) 580-3278

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

77 W Granada Blvd
Ormond Beach, FL 32174-6302
Phone (904) 677-0453

825 Blowing Rock Blvd
Suite B
Lenoir, NC 28645-3709
Phone (828) 991-0999

955 2ND St NE
Hickory, NC 28601-3840
Phone (423) 476-5990

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Helena, MT, CCN 277017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9102838FLMDPhysician Assistant
0010-02065NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group Inc CurrentSince Mar 5, 2026 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Mar 5, 2026 Accepting new patients
Fastmed Primary Care, P.C. PastSince Dec 10, 2023 Accepting new patients
Winnebago Indian Health Service Past Accepting new patients
Southland Emergency Medical Services, L.L.C Past Accepting new patients

Locations

2293 Sugar Hill Rd
#D
Marion, NC 28752
Phone (828) 652-8727

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

695 W Fleming Dr
Morganton, NC 28655
Phone (828) 580-3278

Organizations & group practices 12

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 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1609969674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 PRALEY ST NW",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286902328",
            "telephone_number": "321-297-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 US HIGHWAY 70 SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286025164",
            "telephone_number": "828-267-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 S Nova Rd",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321746115",
            "country_code": "US",
            "telephone_number": "386-673-9949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 Renzulli Rd",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321681726",
            "country_code": "US",
            "telephone_number": "386-663-3061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 N Stone St",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327203256",
            "country_code": "US",
            "telephone_number": "386-261-8608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9102838",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02065",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02065",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005331",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9102838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.