Jessica Marie Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10411 Issued in AZ

Practice address

10240 W Indian School Rd Ste 100
Phoenix, AZ 85037-5905

Phone

(480) 821-3600

NPI assigned

Apr 19, 2024

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

University of South Carolina School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Momdoc, LLC

  dba MomDoc Mi Doctora

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1184780355
  Medicare reassignment Care Compare group
• Healthy Pregnancy Perinatology, LLC

  • Maternal & Fetal Medicine Physician
  • Gilbert, AZ
  • NPI 1467725812
  NPD (past)

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1710732177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375905",
            "telephone_number": "480-821-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Johnson, LCSW
• Jennifer Lynn Johnson, D.C.
• Jennifer Lynn Johnson
• Jeremy Michael Johnson, L.P.N.
• Jessica Johnson, DPT
• Jia Jadalhia Johnson, RN
• John Arve Johnson, DDS
• Joseph Michael Johnson, MD
• Joshua C Johnson, LCSW
• Julie Christina Johnson

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.