Sadie Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1794 Issued in NE

Practice address

816 22ND Ave
Suite 100
Kearney, NE 68845

Phone

(308) 991-8621

NPI assigned

Feb 3, 2014

Last updated

Feb 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phelps Memorial Health CenterGroup PAC ID 9931011947, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps Memorial Health Center Hospital, Holdrege, NE, CCN 281362
• CHI Health Nebraska Heart Hospital, Lincoln, NE, CCN 280128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Phelps Memorial Health Center

  • Certified Registered Nurse Anesthetist
  • Holdrege, NE
  • NPI 1871528851

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• North Platte Nebraska Hospital Corporation

  dba Great Plains Health

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment
• Phelps Memorial Health Center

  • Critical Access Hospital
  • Holdrege, NE
  • NPI 1629035936
  Medicare reassignment
• North Platte Nebraska Hospital Corporation

  dba Great Plains Health

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD
• Phelps Memorial Health Center

  dba Phelps Medical Group

  • Rural Health Clinic/Center
  • Holdrege, NE
  • NPI 1891189809

  Physician Assistant

  NPD

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

• Nebraska Heart Hospital

  dba CHI Health Nebraska Heart

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1699718437
  Care Compare affiliation
• Phelps Memorial Health Center

  • Critical Access Hospital
  • Holdrege, NE
  • NPI 1629035936
  Care Compare affiliation

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1942623541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 WEST 45TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68845",
            "telephone_number": "308-991-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 22ND AVE",
            "address_2": "SUITE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68845",
            "telephone_number": "308-991-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SADIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandy Jane Johnson, OD
• Michael Saul Johnson
• Rochelle R Johnson, RN
• Rodney L. Johnson, MD
• Ronda Johnson
• Shanelle Lynn Johnson
• Tayvian Johnson
• Madison Johnston
• Peggy Ann Johnston, R.D.
• Clinton C Jones, MD

• Physician Assistant in Kearney, NE
• Providers in Kearney, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.