Active NPI
Jill M Johnson, PA-C
- Physician Assistant
- Anchorage, AK
National Provider Identifier
1861574493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 405
- Practice address
- 1217 E 10TH Ave
Anchorage, AK 99501-4003 - Phone
- (907) 257-4652
- Fax
- (907) 792-6546
- NPI assigned
- Oct 20, 2006
- 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 | 405 | AK | Primary |
Addresses
Primary practice location
1217 E 10TH Ave
Anchorage, AK 99501-4003
Mailing address
PO Box 201849
Anchorage, AK 99520-1849
Phone (907) 792-6561
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 405 | AK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861574493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 201849",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995201849",
"telephone_number": "907-792-6561",
"fax_number": "907-792-6546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 E 10TH AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995014003",
"telephone_number": "907-257-4652",
"fax_number": "907-792-6546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JILL",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.