Individual provider Active NPI

Chelsea Johnson, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1770164105
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11218 Issued in NC
Practice address
4309 Medical Park Dr Ste 200
Durham, NC 27704-2389
Phone
(919) 471-4484
Fax
(919) 477-6131
NPI assigned
Apr 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11218 NC Primary

Addresses

Primary practice location

4309 Medical Park Dr Ste 200
Durham, NC 27704-2389

Mailing address

2675 Winkler Ave Ste 200
Fort Myers, FL 33901-9328
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210505001155 NC Practitioner - Physician Assistant 6305255282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group of NC, PLLCGroup PAC ID 2567593635, 27 clinicians

Practice addresses (Care Compare)

4309 Medical Park Dr
Suite 200
Durham, NC 27704-2389
Phone (919) 471-4484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-11218NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group of NC, PLLC CurrentSince Mar 23, 2026 Accepting new patients

Locations

2675 Winkler Ave
Ste 200
Fort Myers, FL 33901

5107 Southpark Dr
Ste 104
Durham, NC 27713
Phone (919) 477-6900

4309 Medical Park Dr
Ste 200
Durham, NC 27704
Phone (919) 471-0900

4205 Ben Franklin Blvd
Durham, NC 27704
Phone (919) 477-6900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2523/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1770164105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019328",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 MEDICAL PARK DR STE 200",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042389",
            "telephone_number": "919-471-4484",
            "fax_number": "919-477-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHELSEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.