Individual provider Active NPI

Ava C Johnson, NP

  • Family Nurse Practitioner
  • Chincoteague, VA
National Provider Identifier
1669635447
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167876 Issued in VA
Practice address
4049 Main St
Chincoteague, VA 23336-2406
Phone
(757) 336-3682
Fax
(757) 336-3703
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024167876 VA Primary

Addresses

Primary practice location

4049 Main St
Chincoteague, VA 23336-2406

Mailing address

4049 Main St
Chincoteague, VA 23336-2406
Phone (757) 336-3682

Other names 1

  • Ava Jean Cole Former name

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
I20220303000483 NC Practitioner - Nurse Practitioner 8224103254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Community Health Services, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Metropolitan Community Health Services, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Metropolitan Community Health Services, Inc Current Accepting new patients
Bayside Family Practice,L.L.C. Past Accepting new patients

Locations

120 W Martin Luther King Jr Dr
Washington, NC 27889
Phone (252) 644-7003

120 W Martin Luther King Jr Dr
#J
Washington, NC 27889
Phone (252) 940-0602

Interoperability endpoints

  • Direct secure messaging: ajohnson365429@direct.ochin.org

Organizations & group practices 4

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1669635447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 MAIN ST",
            "city": "CHINCOTEAGUE",
            "state": "VA",
            "postal_code": "233362406",
            "telephone_number": "757-336-3682",
            "fax_number": "757-336-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 MAIN ST",
            "city": "CHINCOTEAGUE",
            "state": "VA",
            "postal_code": "233362406",
            "telephone_number": "757-336-3682",
            "fax_number": "757-336-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AVA",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVA",
            "last_name": "COLE",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chincoteague, VA

Sources for this page

Verify at the official NPI Registry.