Pamela Ann Johnson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9401228 Issued in NC

Practice address

2701 Statesville Ave
Charlotte, NC 28206

Phone

(980) 302-8521

Fax

(980) 302-8525

NPI assigned

Feb 9, 2006

Last updated

Mar 23, 2023By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  dba Novant Health Gynecologic Oncology Associates

  • Gynecologic Oncology Physician
  • Charlotte, NC
  • NPI 1902846330
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1639142631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1166",
            "fax_number": "704-384-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 STATESVILLE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28206",
            "telephone_number": "980-302-8521",
            "fax_number": "980-302-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11840 Southmore Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282774466",
            "country_code": "US",
            "telephone_number": "704-384-1166",
            "fax_number": "704-384-1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9401228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791074V",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjohnson15555@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "11840 Southmore Dr",
            "address_2": "Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282774466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Johnson
• Neco Johnson
• Nichole Lynette Johnson, MD
• Nicole Alexandra Johnson, LMBT
• Nolan Cornelius Johnson, MD
• Patricia Johnson
• Patricia Vanessa Johnson, M.S.-ED.S., NCC, LPC
• Pheadra Johnson
• Rachael Sue Johnson
• Rachel Johnson

• Pediatrics Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.