Victoria White Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3679 Issued in TN

Practice address

403 N State of Franklin Rd
Johnson City, TN 37604

Phone

(423) 431-7042

Fax

(423) 431-9042

NPI assigned

Jul 3, 2018

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 identifiers 1

Other names 1

• Victoria P White Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Lincoln Memorial University Medical Department, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians

National Addiction Specialists LLCGroup PAC ID 1254709959, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment Care Compare group
• National Addiction Specialists LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Brentwood, TN
  • NPI 1477186336
  Medicare reassignment Care Compare group
• State of Franklin Healthcare Associates PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1063459410
  Medicare reassignment
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment
• Blue Ridge Medical Management Corporation

  • Internal Medicine Physician
  • Elizabethton, TN
  • NPI 1558831115
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• East Tennessee Healthcare Holdings Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gray, TN
  • NPI 1033624853
  NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1770079675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046034",
            "telephone_number": "423-431-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-431-7042",
            "fax_number": "423-431-9042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5511 Virginia Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277611",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 Greystone Dr Ste 102A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787312314",
            "country_code": "US",
            "telephone_number": "737-381-1717",
            "fax_number": "737-381-1717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Med Tech Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042641",
            "country_code": "US",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7501 Fannin St Ste 702",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770541938",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "WHITE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSES",
            "identifier": "3679",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "WHITE",
            "middle_name": "P",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael D Johnson, PA
• Michelle Eileen Johnson, M.S., R.D., LDN
• Phung Pham Johnson, DMD
• Roger Dale Johnson, FNP
• Ruth D Johnson, MSN
• Brian David Johnston, ATC, OTC
• Chambless Rand Johnston III, MD
• Emmalea Elizabeth Johnston, NP-C
• James Robert Johnston Jr., MD
• Jones Chiropractic Clinic

• Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.