Individual provider Active NPI

Steven Wesley Johnson, PA-C

  • Physician Assistant
  • Dothan, AL
National Provider Identifier
1912323569
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 946 Issued in AL
Practice address
1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone
(334) 793-8111
NPI assigned
Mar 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 PA 946 AL Primary

Addresses

Primary practice location

1108 Ross Clark Cir
Dothan, AL 36301-3022

Mailing address

625 Lawson Dr
Troy, AL 36081-3852
Phone (334) 201-4199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140711000639 AL Practitioner - Physician Assistant 9931324720 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

125 20TH St S
Suite 103
Birmingham, AL 35233-2019
Phone (205) 801-5251

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 28, 2024 Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority Physician Assistant CurrentSince Apr 7, 2014 Accepting new patients
Houston County Healthcare Authority Physician Assistant CurrentSince Apr 7, 2014 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Interoperability endpoints

  • Direct secure messaging: swjohnson@direct.uabmedicine.org

Organizations & group practices 7

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 2

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": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1912323569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 LAWSON DR",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360813852",
            "telephone_number": "334-201-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEVEN",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA 946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.