Thomas W Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107926 Issued in FL

Practice address

600 Nokomis Ave S
Suite 102 & 203
Venice, FL 34285-3209

Phone

(941) 486-6979

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gulf Coast Hma Physician Management LLC

  dba Gulf Coast Medical Group

  • Internal Medicine Physician
  • Venice, FL
  • NPI 1407806094
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1780652974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NOKOMIS AVE S",
            "address_2": "SUITE 102 & 203",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853209",
            "telephone_number": "941-486-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NOKOMIS AVE S",
            "address_2": "SUITE 102 & 203",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853209",
            "telephone_number": "941-486-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "544",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P. Johnson, D.C.
• Keith B Johnson, MD
• Kendall Dewayne Johnson, COTA
• Kristen Johnson
• Mark Anthony Johnson, MD
• Victoria S Johnson, MD
• Amelia Jones, MS, HHA, CNA
• Michael Jones, PT
• Aja Jordan
• Jenin Jose, MD

• Physician Assistant in Venice, FL
• Providers in Venice, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.