NPIMap

Individual provider Active NPI

Paige Wilbanks Johnson

  • Physician Assistant
  • Lexington, SC
National Provider Identifier
1659067809
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4925 Issued in SC
Practice address
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone
(803) 296-7846
Fax
(803) 296-9699
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4925 SC Primary

Addresses

Primary practice location

104 Saluda Pointe Dr
Lexington, SC 29072-7295

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

111 Doctors Dr
Greenville, SC 29605-5622
Phone (864) 797-7061

Other identifiers 1

IdentifierTypeStateIssuer
6366PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012000509 SC Practitioner - Physician Assistant 3072968924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone (803) 296-7846

1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 434-6771

14 Richland Medical Park Dr
Suite 200
Columbia, SC 29203-6882
Phone (803) 296-7846

300 Palmetto Health Pkwy
Columbia, SC 29212-1762

400 Palmetto Health Pkwy
Columbia, SC 29212-1760
Phone (803) 296-5579

Hospital & facility affiliations

  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4925SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 31, 2023 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 31, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 31, 2023 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 296-9200

1120 Roberts Branch Pkwy
#200
Columbia, SC 29203

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

111 Doctors Dr
Greenville, SC 29605
Phone (864) 242-4683

104 Saluda Pointe Dr
Lexington, SC 29072
Phone (803) 296-9200

Interoperability endpoints

  • Direct secure messaging: pjohnson461295@direct.ghs.myhfn.org

Organizations & group practices 5

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 10

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1659067809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SALUDA POINTE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727295",
            "telephone_number": "803-296-7846",
            "fax_number": "803-296-9699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055622",
            "country_code": "US",
            "telephone_number": "864-797-7061",
            "fax_number": "864-797-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAIGE",
        "middle_name": "WILBANKS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6366PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.