Individual provider Active NPI

Joshua Beaty Johnson, PA-C

  • Medical Physician Assistant
  • North Little Rock, AR
National Provider Identifier
1780055178
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
P-T1547 Issued in AR
Practice address
4617 E McCain Blvd
North Little Rock, AR 72117-2904
Phone
(501) 945-0680
NPI assigned
Oct 12, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X P-T1547 AR Primary

Addresses

Primary practice location

4617 E McCain Blvd
North Little Rock, AR 72117-2904

Mailing address

4617 E McCain Blvd
North Little Rock, AR 72117-2904
Phone (501) 945-0680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160216002088 AR Practitioner - Physician Assistant 3971808700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Arkansas College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9500 Kanis Rd
Suite 410
Little Rock, AR 72205-6377
Phone (501) 202-1500

Hospital & facility affiliations

  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P-T1547ARMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Oct 24, 2024 Accepting new patients
Arkansas Health Group CurrentSince Oct 24, 2024 Accepting new patients
Epoch Health - Conway, PLLC PastSince Jun 1, 2014 Accepting new patients
Arkansas Health Group Past Accepting new patients
Arkansas Urology, P.a. PastSince Aug 10, 2020 Accepting new patients
Hot Springs MRI Center Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9500 Kanis Rd
Ste 410
Little Rock, AR 72205
Phone (501) 202-1500

Interoperability endpoints

  • Direct secure messaging: jjohnson125021@direct.baptist-healthar.org
  • FHIR API: https://api.platform.athenahealth.com/10448/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1780055178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 E MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172904",
            "telephone_number": "501-945-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 E MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172904",
            "telephone_number": "501-945-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSHUA",
        "middle_name": "BEATY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "P-T1547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.