Individual provider Active NPI

Andrea Marie Johnson, PA

  • Physician Assistant
  • Asheboro, NC
National Provider Identifier
1700939220
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103798 Issued in NC
Practice address
350 N Cox St Ste 28
Asheboro, NC 27203-5514
Phone
(336) 629-6500
Fax
(336) 629-9500
NPI assigned
Jan 19, 2007
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 103798 NC Primary

Addresses

Primary practice location

350 N Cox St Ste 28
Asheboro, NC 27203-5514

Mailing address

350 N Cox St
Ste 28
Asheboro, NC 27203-5514
Phone (336) 629-6500

Other practice location 1

132 W Miller St Ste A
Asheboro, NC 27203-4775
Phone (336) 625-3248

Other identifiers 1

IdentifierTypeStateIssuer
1700939220MedicaidNC

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
I20080516000402 NC Practitioner - Physician Assistant 0840369856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Healthcare Systems LLCGroup PAC ID 7719383538, 64 clinicians

Practice addresses (Care Compare)

237 N Fayetteville St
Asheboro, NC 27203-5573

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103798NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Healthcare Systems, LLC Internal Medicine CurrentSince Sep 12, 2022 Accepting new patients
American Healthcare Systems, LLC CurrentSince Sep 12, 2022 Accepting new patients
American Healthcare Systems, LLC Past Accepting new patients
Randolph Specialty Group Practice Internal Medicine Past Accepting new patients
American Healthcare Systems, LLC Past Accepting new patients

Locations

218 Foust St
Ste C
Asheboro, NC 27203
Phone (336) 625-2333

237 N Fayetteville St
Ste A
Asheboro, NC 27203
Phone (336) 625-3248

237 N Fayetteville St
Ste D
Asheboro, NC 27203
Phone (336) 625-2961

713 S Fayetteville St
Asheboro, NC 27203
Phone (336) 625-2467

514 N Broad St
Seagrove, NC 27341
Phone (336) 873-8045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1700939220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N COX ST",
            "address_2": "STE 28",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035514",
            "telephone_number": "336-629-6500",
            "fax_number": "336-629-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N COX ST STE 28",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035514",
            "telephone_number": "336-629-6500",
            "fax_number": "336-629-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 W Miller St Ste A",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272034775",
            "country_code": "US",
            "telephone_number": "336-625-3248",
            "fax_number": "336-625-6629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700939220",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.