Mischelle K Johnson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

16515 S. 40TH St, BLDG 9, Suite 143
Phoenix, AZ 85048

Phone

(480) 712-8319

Fax

(480) 712-1305

NPI assigned

Nov 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AZ, FL, WA, OR4 enrollments

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 4

Specialty

Physician Assistant

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athena Medical GroupGroup PAC ID 8921358706, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

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.

• Athena Medical Group

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1164918124

  FL, OR, WA

  Medicare reassignment Care Compare group
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment
• Estrella Specialty Medical Care P C

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1538239876
  Medicare reassignment
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432
  Medicare reassignment
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • San Tan Valley, AZ
  • NPI 1063573079
  NPD
• Atlas Medical Systems, PLLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1396420758
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Team Physicians of Arizona PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1710915764

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1801975982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S. 40TH ST, BLDG 9, SUITE 143",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 S. 40TH ST, BLDG 9, SUITE 143",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Balcones Drive Suite 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78731",
            "country_code": "US",
            "telephone_number": "602-888-2344",
            "fax_number": "833-833-2656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Ryland St, Suite 200-A",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "89502",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Balcones Drive Suite 6954",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78731",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1942 Broadway St, Suite 314C",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "80302",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14780 W. Mountain View Blvd.",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853747280",
            "country_code": "US",
            "telephone_number": "623-374-7774",
            "fax_number": "877-796-5302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 5th Avenue, Ste 101-800",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98104",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 4th St N, Ste 300",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "33702",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MISCHELLE",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "AZ",
            "license": "2421",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "280764",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANPCB",
            "identifier": "F08220175",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559346",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA61331068",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9116211",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Johnson Jr.
• Michael James Johnson, M.D.
• Michael Lee Johnson, O.D.
• Michael Scott Johnson, LMSW-T
• Michelle Renee Johnson, R.N.
• Monique M Johnson, DPT
• Mystie L Johnson, MD
• Nancy L Johnson
• Nancy L Johnson
• Nicole Johnson, FNP-BC

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.