Individual provider Active NPI

Erik Kjell Johnson, PA-C

  • Physician Assistant
  • Willoughby, OH
National Provider Identifier
1790108421
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
36000 Euclid Ave
Emergency Department
Willoughby, OH 44094-4625
Phone
(440) 953-9600
NPI assigned
Jan 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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 Primary

Addresses

Primary practice location

36000 Euclid Ave
Emergency Department
Willoughby, OH 44094-4625

Mailing address

36000 Euclid Ave
Emergency Department
Willoughby, OH 44094-4625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140304001990 OH Practitioner - Physician Assistant 0042440430 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Urgent Care, LLCGroup PAC ID 3971985607, 109 clinicians

Practice addresses (Care Compare)

14800 Madison Ave
Lakewood, OH 44107-4010
Phone (216) 925-4600

1634 Snow Rd
Parma, OH 44134-2719
Phone (440) 368-1520

3909 Orange PL
Suite 2100
Beachwood, OH 44122-8400
Phone (440) 809-8810

5901 E Royalton Rd
Suite 1400B
Broadview Heights, OH 44147-3532
Phone (440) 499-5900

6836 Ridge Rd
Parma, OH 44129-5627
Phone (216) 490-1120

716 N Court St
Medina, OH 44256-1748
Phone (330) 426-8700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, PC CurrentSince Jan 28, 2022 Accepting new patients
University Hospitals Urgent Care, LLC CurrentSince Mar 6, 2023 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Jan 28, 2022 Accepting new patients

Locations

3909 Orange Pl
Ste 2100
Beachwood, OH 44122
Phone (216) 896-1800

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

Interoperability endpoints

  • Direct secure messaging: ejohnson593784@ehrdirect.uhhospitals.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1790108421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-953-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIK",
        "middle_name": "KJELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.