Quan Johnson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

94866 Issued in GA

Practice address

5135 Wrightsboro Rd Ste B
Grovetown, GA 30813-2803

Phone

(706) 854-2500

Fax

(706) 854-2559

NPI assigned

May 20, 2008

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14928/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/AGBECA/Endpoint/AGBECA
• Direct secure messaging: qjohnson494698@direct.conehealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomasville-Archdale Pediatrics, PLLC

  • Pediatrics Physician
  • Thomasville, NC
  • NPI 1427018894
  Medicare reassignment NPD
• Pediatric Partners of Augusta, LLC

  • Pediatrics Physician
  • Evans, GA
  • NPI 1417064924
  NPD
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  NPD (past)
• Melissa Jadick

  • Pediatrics Physician
  • Augusta, GA
  • NPI 1013927946
  NPD (past)
• Thomasville/Archdale Pediatrics PLLC

  • Registered Dietitian
  • Thomasville, NC
  • NPI 1891094553
  NPD (past)
• Valcourt Pediatric Associates

  • Pediatrics Physician
  • Walterboro, SC
  • NPI 1396012126
  NPD (past)

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1699932418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 TOWN PARK BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093487",
            "telephone_number": "706-854-2500",
            "fax_number": "706-854-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 WRIGHTSBORO RD STE B",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132803",
            "telephone_number": "706-854-2500",
            "fax_number": "706-854-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 Dantignac St Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012796",
            "country_code": "US",
            "telephone_number": "706-854-2500 x232",
            "fax_number": "706-854-2559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 Town Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093487",
            "country_code": "US",
            "telephone_number": "706-854-2500 x232",
            "fax_number": "706-854-2559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "QUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "94866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003284191D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003284191A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003284191B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "qjohnson494698@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1816 Richardson Dr",
            "city": "Reidsville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273205434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Earnest Calvin Bernard Jenkins Jr., MT013231
• Alyssa Erinn Lynn Johnson, LPC
• Johnay Johnson, RN
• Lawanda Johnson
• Nathaniel Johnson, LPC
• Scout Virginia Johnson
• Amanda Johnstun
• Caroline McKinley Jones, PHARMD
• Jonathan Jones, PHARMD
• Melissa Mobley Jordan, D.M.D.

• Pediatrics Physician in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.