Individual provider Active NPI

Laney Johnson, CPNP-PC

  • Pediatric Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1962258301
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
GAA-NP002240 Issued in GA
Practice address
2315 Central Ave Ste a
Augusta, GA 30904-6246
Phone
(706) 792-5040
NPI assigned
Apr 26, 2024
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X GAA-NP002240 GA Primary

Addresses

Primary practice location

2315 Central Ave Ste a
Augusta, GA 30904-6246

Mailing address

7027 Fenwick St
Graniteville, SC 29829-4076
Phone (478) 290-7834

Other practice location 1

229 Addison Sq
Evans, GA 30809-5526
Phone (706) 364-6045

Other practice location 2

4106 Columbia Rd Ste 103
Martinez, GA 30907-1482
Phone (706) 863-1440

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP002240GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Multispecialty Group PastSince Apr 28, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1962258301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7027 FENWICK ST",
            "city": "GRANITEVILLE",
            "state": "SC",
            "postal_code": "298294076",
            "telephone_number": "478-290-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 CENTRAL AVE STE A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046246",
            "telephone_number": "706-792-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 Addison Sq",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308095526",
            "country_code": "US",
            "telephone_number": "706-364-6045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4106 Columbia Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "GA",
            "postal_code": "309071482",
            "country_code": "US",
            "telephone_number": "706-863-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LANEY",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "GAA-NP002240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.