Active NPI
Anjinetta Yates-Johnson, P.A.
- Physician Assistant
- Mount Pleasant, SC
National Provider Identifier
1790988863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 712
- Practice address
- 900 Bowman Rd
Suite 103
Mount Pleasant, SC 29464-3203 - Phone
- (843) 881-5844
- Fax
- (843) 881-5012
- NPI assigned
- Jun 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 712 | SC | Primary |
Addresses
Primary practice location
900 Bowman Rd
Suite 103
Mount Pleasant, SC 29464-3203
Mailing address
900 Bowman Rd
Suite 103
Mount Pleasant, SC 29464-3203
Phone (843) 881-5844
Other names 1
- Miss Anjinetta Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 712 | SC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790988863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 BOWMAN RD",
"address_2": "SUITE 103",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643203",
"telephone_number": "843-881-5844",
"fax_number": "843-881-5012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 BOWMAN RD",
"address_2": "SUITE 103",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643203",
"telephone_number": "843-881-5844",
"fax_number": "843-881-5012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES-JOHNSON",
"first_name": "ANJINETTA",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANJINETTA",
"last_name": "JOHNSON",
"prefix": "MISS",
"credential": "P.A.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.