Active NPI
Laney Johnson, CPNP-PC
- Pediatric Nurse Practitioner
- Augusta, GA
National Provider Identifier
1962258301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- GAA-NP002240
- Practice address
- 2315 Central Ave Ste a
Augusta, GA 30904-6246 - Phone
- (706) 792-5040
- NPI assigned
- Apr 26, 2024
- Last updated
- Apr 26, 2024
- 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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| GAA-NP002240 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Multispecialty Group | Past | 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.
-
dba Covenant Pediatrics
- Pediatrics Physician
- Martinez, GA
- NPI 1942376918
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.