Active NPI
Sherry Tang Johnson, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 2016-02551
- Practice address
- 4420 Lake Boone TRL
Raleigh, NC 27607-7505 - Phone
- (919) 784-3100
- NPI assigned
- Apr 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 2016-02551 | NC | Primary |
Addresses
Primary practice location
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Mailing address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Saint Louis University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3063
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016-02551 | NC | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Rex Pathology Associates PA | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
5700 Southwyck Blvd
Toledo, OH 43614
Organizations & group practices 3
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Raleigh, NC
- NPI 1255307187
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Raleigh, NC
- NPI 1497797088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1740623107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 SOUTHWYCK BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436141509",
"telephone_number": "800-288-8325",
"fax_number": "419-866-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077505",
"telephone_number": "919-784-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHERRY",
"middle_name": "TANG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-16",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NC",
"license": "2016-02551",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10800 Magnolia Ave",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925053043",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.