Individual provider Active NPI

Ryan Zachary Johnson, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1659884062
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07701 Issued in NC
Practice address
3100 Blue Ridge Rd
Raleigh, NC 27612-8036
Phone
(919) 719-2250
NPI assigned
Nov 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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 0010-07701 NC Primary

Addresses

Primary practice location

3100 Blue Ridge Rd
Raleigh, NC 27612-8036

Mailing address

3100 Blue Ridge Rd
Raleigh, NC 27612-8036

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180411002634 NC Practitioner - Physician Assistant 1850654500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 233-2300

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 736-1110

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 934-8171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA CurrentSince Dec 1, 2020 Accepting new patients
NHCS Physicians Inc CurrentSince Oct 14, 2024 Accepting new patients
Wake Emergency Physicians PA CurrentSince Dec 1, 2020 Accepting new patients
NHCS Physicians Inc CurrentSince Oct 14, 2024 Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

550 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 451-3411

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

Interoperability endpoints

  • Direct secure messaging: rjohnson972371@direct.unc.nchie.net

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.

Hospital & facility affiliations 4

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1659884062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128036",
            "telephone_number": "919-719-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "middle_name": "ZACHARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.