Charysse Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3209 Issued in CT

Practice address

1030 Boulevard
West Hartford, CT 06119-1801

Phone

(860) 986-6440

NPI assigned

Oct 17, 2014

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 names 1

• Charysse Brown Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1851571608

  CT

  Medicare reassignment NPD
• American Current Care P.a.

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1740684901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TOWNLEY ST APT H3",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051864",
            "telephone_number": "917-302-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BOULEVARD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191801",
            "telephone_number": "860-986-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARYSSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARYSSE",
            "last_name": "BROWN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Nazarian MD LLC
• Kathleen Johndrow, LCSW
• Johnson Physical Therapy PLLC
• Carter Steven Johnson, MD
• Chantelle Johnson
• Steve Johnson
• Lisabeth Emerson Johnston, PHD APRN
• Jonathan a Kost, MD LLC
• Daniel Jones, PH.D.
• Karen Meredith Jones, MD

• Physician Assistant in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.