Individual provider Active NPI

Yavonne L Johnson, PA

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1811293103
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(704) 323-2000
NPI assigned
Feb 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 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

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20161116000107 DC Practitioner - Physician Assistant 2961661582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

6410 Rockledge Dr
Bethesda, MD 20817-1844

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011
  • Medstar National Rehabilitation Hospital Inpatient rehabilitation facility, Washington, DC, CCN 093025

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp CurrentSince Sep 24, 2016 Accepting new patients
Washington Hospital Center Corp CurrentSince Sep 24, 2016 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1811293103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YAVONNE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.