Amanda Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4700 E 13 Mile Rd
Warren, MI 48092-4438

Phone

(586) 576-0431

NPI assigned

Dec 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mandi Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: ajohnson655620@direct.hfhs.org

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.

• Michigan Center for Fertility and Womens Health, PLC

  • Reproductive Endocrinology Physician
  • Warren, MI
  • NPI 1952696346

  Single Specialty

  NPD (past)
• Michigan Center Ivf, PLLC

  • Ambulatory Fertility Facility
  • Warren, MI
  • NPI 1427357821
  NPD (past)

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1649867151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924438",
            "telephone_number": "586-576-0431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 W Warren Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011347",
            "country_code": "US",
            "telephone_number": "313-577-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDI",
            "last_name": "JOHNSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Renu John, RPH
• Alan Johns, LLMSW
• La Donna Johns, OTR
• Alisha D Johnson, N.P.
• Aliyah Johnson
• Barbara Jean Johnson
• Brittany Johnson
• Charlotte Johnson
• Davina Johnson
• Harold Cortez Johnson, DDS

• Physician Assistant in Warren, MI
• Providers in Warren, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.