Individual provider Active NPI

Andrea Johnson, M.D.

  • Obstetrics & Gynecology Physician
  • Decatur, GA
National Provider Identifier
1699862524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
034377 Issued in GA
Practice address
755 Commerce Dr
Suite 300
Decatur, GA 30030-2627
Phone
(404) 593-2739
Fax
(404) 593-2746
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 034377 GA Primary

Addresses

Primary practice location

755 Commerce Dr
Suite 300
Decatur, GA 30030-2627

Mailing address

755 Commerce Dr
Suite 300
Decatur, GA 30030-2627
Phone (404) 593-2739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20080116000402 GA Practitioner - Obstetrics/Gynecology 2062593072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Pittsburgh School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Women'S Health and Wellness Center, Inc.Group PAC ID 7618058629, 2 clinicians

Practice addresses (Care Compare)

755 Commerce Dr
Suite 300
Decatur, GA 30030-2615
Phone (404) 593-2739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034377GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Women'S Health & Wellness Center, Inc. Obstetrics & Gynecology CurrentSince Feb 1, 2007 Accepting new patients
Morehouse Healthcare, Inc. Obstetrics & Gynecology PastSince Jul 1, 2012 Accepting new patients

Locations

755 Commerce Dr
Ste 300
Decatur, GA 30030
Phone (404) 593-2739

Interoperability endpoints

  • Direct secure messaging: andrea.johnson.1@3029.direct.athenahealth.com

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699862524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302627",
            "telephone_number": "404-593-2739",
            "fax_number": "404-593-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302627",
            "telephone_number": "404-593-2739",
            "fax_number": "404-593-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "034377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.