Cheri K. Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.930 Issued in AL

Practice address

171 Village Lake Dr
Pooler, GA 31322-2147

Phone

(912) 349-5165

NPI assigned

Oct 11, 2006

Last updated

Sep 6, 2016By the provider in NPPES

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• Athens-Clarke Emergency Specialists

  • Emergency Medicine Physician
  • Athens, GA
  • NPI 1194762237
  NPD (past)
• Georgia Emergency Associates

  • Emergency Medicine Physician
  • Rincon, GA
  • NPI 1528098290
  NPD (past)
• Memorial Health Urgentone, Inc.

  dba UrgentOne Savannah Mall

  • Emergency Medicine Physician
  • Savannah, GA
  • NPI 1801818844

  Physician Assistant

  NPD (past)
• Sterling Emergency Services of the Southeast Inc

  • Emergency Medicine Physician
  • Eatonton, GA
  • NPI 1992763627
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1932297967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 BUCKNER CIR",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362054413",
            "telephone_number": "912-704-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 VILLAGE LAKE DR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222147",
            "telephone_number": "912-349-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHERI",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003850",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002280G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00853761",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002280F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMHS TRICARE SOUTH - SAVANNAH",
            "identifier": "582203199-004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMHS TRICARE SOUTH - POOLER",
            "identifier": "582203199-009",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0980PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Jimenez
• Andrea Lakia Jivens
• Evelia Johnsen, NP
• Celandria Johnson-Foster
• Brittany Marie Johnson
• Gary M Johnson Jr., DMD
• Porsha Johnson
• Yawna Jones-Greene
• Amonyah Ti'Kayla Jones
• Fatima Jones

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.