Individual provider Active NPI

Renea Doughton-Johnson, NP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1780864793
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN072764 Issued in GA
Practice address
1520 Avenue PL
Atlanta, GA 30329-4015
Phone
(404) 639-5575
NPI assigned
Nov 7, 2007
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN072764 GA Primary

Addresses

Primary practice location

1520 Avenue PL
Atlanta, GA 30329-4015

Mailing address

1520 Avenue PL
Atlanta, GA 30329-4015
Phone (404) 639-5575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080401000587 GA Practitioner - Nurse Practitioner 0345327359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Apr 1, 2025 Accepting new patients
Vpa PC CurrentSince Apr 1, 2025 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

1372 Peachtree St NE
Ste 100
Atlanta, GA 30309
Phone (470) 964-1700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1780864793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 AVENUE PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294015",
            "telephone_number": "404-639-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 AVENUE PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294015",
            "telephone_number": "404-639-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTON-JOHNSON",
        "first_name": "RENEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN072764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.