Individual provider Active NPI

Jasmine Latrice Johnson

  • Clinical Social Worker
  • Kernersville, NC
National Provider Identifier
1619543733
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016728 Issued in NC
Practice address
1695 Kernersville Medical Pkwy
Kernersville, NC 27284-7159
Phone
(336) 515-5000
NPI assigned
May 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C016728 NC Primary

Addresses

Primary practice location

1695 Kernersville Medical Pkwy
Kernersville, NC 27284-7159

Mailing address

5759 Cross Creek Cir Apt D
Indianapolis, IN 46254-4730
Phone (773) 682-6691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240518000573 NC Practitioner - Clinical Social Worker 4385085547 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians

Practice addresses (Care Compare)

3064 Wake Forest Rd
Suite 1271
Raleigh, NC 27609-7844
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C016728NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc CurrentSince Mar 30, 2024 Accepting new patients
Brightside Medical of New Jersey, P.C. CurrentSince Dec 1, 2025 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Salisbury Vamc CurrentSince Jan 21, 2022 Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Mar 30, 2024 Accepting new patients
Therapeutic Connections, PLLC CurrentSince Jan 4, 2026 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

24 Battleground Ct
Ste A
Greensboro, NC 27408
Phone (336) 907-4054

931 3rd St
Greensboro, NC 27405
Phone (336) 890-2700

700 Walter Reed Dr
Greensboro, NC 27403
Phone (336) 832-9600

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

1695 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 515-5000

3064 Wake Forest Rd
Raleigh, NC 27609
Phone (415) 360-3349

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1622332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1619543733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5759 CROSS CREEK CIR APT D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462544730",
            "telephone_number": "773-682-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 KERNERSVILLE MEDICAL PKWY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847159",
            "telephone_number": "336-515-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JASMINE",
        "middle_name": "LATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-30",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.