Malinda Johnson, PA-C, OTR

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008486 Issued in GA

Practice address

354 Newnan Crossing Byp Ste 200
Newnan, GA 30265-2434

Phone

(770) 460-4747

NPI assigned

Apr 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1801014329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 NEWNAN CROSSING BYP STE 200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652434",
            "telephone_number": "770-460-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Wellford St",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224013176",
            "country_code": "US",
            "telephone_number": "540-361-1830",
            "fax_number": "540-361-1829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6160 Kempsville Cir Ste 200B",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "23502",
            "country_code": "US",
            "telephone_number": "757-321-3300",
            "fax_number": "757-321-3330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Taylor Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "23321",
            "country_code": "US",
            "telephone_number": "757-881-1137",
            "fax_number": "757-881-1138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Taylor Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "23321",
            "country_code": "US",
            "telephone_number": "757-881-1137",
            "fax_number": "757-881-1138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Taylor Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "23321",
            "country_code": "US",
            "telephone_number": "757-881-1137",
            "fax_number": "757-881-1138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Taylor Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "23321",
            "country_code": "US",
            "telephone_number": "757-881-1137",
            "fax_number": "757-881-1138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Omni Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "23606",
            "country_code": "US",
            "telephone_number": "757-873-2562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Omni Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "23606",
            "country_code": "US",
            "telephone_number": "757-873-2562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6262 Veterans Pkwy",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319093540",
            "country_code": "US",
            "telephone_number": "706-324-6661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MALINDA",
        "credential": "PA-C, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2021-01-29",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006226",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "VVS858A",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernard Thornton Johnson
• Carol Johnson, NP
• Kristina B Johnson
• Latasha Johnson
• Leslie J. Johnson, FNP-C
• Margaret Pringle Johnson
• Patricia Leigh Johnson, ND
• Railan Diana Johnson, RBT
• Scott Raymond Johnson, D.D.S.
• Shakia Johnson, APRN

• Physician Assistant in Newnan, GA
• Providers in Newnan, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.