Jessica Michelle Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3179 Issued in SC

Practice address

110A Springhall Dr
Goose Creek, SC 29445-5335

Phone

(843) 779-6444

Fax

(843) 990-5068

NPI assigned

Aug 7, 2019

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

Medicare fee-for-service enrollment

Enrolled in SC

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

Medical University of South Carolina College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Liberty Doctors LLCGroup PAC ID 0840466017, 44 clinicians

Palmetto Primary Care Physicians LLCGroup PAC ID 4880508068, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston Home health agency, North Charleston, SC, CCN 427005
• Trident Medical Center Hospital, Charleston, SC, CCN 420079

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohnson@libertydoctors.ssdirect.aprima.com

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.

• Liberty Doctors LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1700162203
  Medicare reassignment Care Compare group NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  Medicare reassignment Care Compare group
• Liberty Doctors, LLC

  • Family Medicine Physician
  • North Charleston, SC
  • NPI 1376854406
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1720029713
  NPD
• Liberty Doctors LLC

  • Internal Medicine Physician
  • Moncks Corner, SC
  • NPI 1144299470
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Home Health of South Carolina LLC

  • Home Health Agency
  • North Charleston, SC
  • NPI 1033177290
  Care Compare affiliation
• Trident Medical Center, LLC

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1760037733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 KENTWOOD CIR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129383",
            "telephone_number": "843-834-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110A SPRINGHALL DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455335",
            "telephone_number": "843-779-6444",
            "fax_number": "843-990-5068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2079 Charlie Hall Blvd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145834",
            "country_code": "US",
            "telephone_number": "843-554-8488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya R Jenkins, LMSW
• Shelby Jennings
• Vonnie L Jessup
• Charlotte Berry Johnson, PHARMD
• Eric Johnson, MD
• Tiffany Rochelle Johnson, RN CASE MANAGER
• Kim Johnston
• Joints in Motion Physical Therapy and Wellness, LLC
• Asaiah Jones, RBT
• Lakia Jones

• Physician Assistant in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.