Mary Elizabeth King Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003419 Issued in IL

Practice address

1040 N Mason Rd
Suite 103
Saint Louis, MO 63141-6399

Phone

(314) 469-7246

NPI assigned

Feb 13, 2009

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Peters Bone and Joint Surgery Inc 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score

94.79 of 100Reported as group

Quality

96.04

Improvement activities

40

Cost

89.88

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 and National Provider Directory roles.

• St Peters Bone & Joint Surgery Inc.

  • Orthopaedic Surgery Physician
  • Saint Peters, MO
  • NPI 1225182157

  MO

  Medicare reassignment Care Compare group
• St Peters Bone & Joint Surgery Inc.

  • Orthopaedic Surgery Physician
  • O Fallon, MO
  • NPI 1386010684
  Care Compare group NPD
• Integrative Spine Care LLC

  • Pain Clinic/Center
  • Chesterfield, MO
  • NPI 1649623240

  MO

  Medicare reassignment
• St Peters Bone & Joint Surgery Inc.

  • Orthopaedic Surgery Physician
  • Wentzville, MO
  • NPI 1538313424
  Care Compare group
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1558258632
  NPD (past)
• Compass Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Charles, MO
  • NPI 1083033591
  NPD (past)
• Manish Suthar MD PC

  • Physical Medicine & Rehabilitation Physician
  • Chesterfield, MO
  • NPI 1992984041
  NPD (past)

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

• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1992944904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 CULPEPPER RIDGE DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217527",
            "telephone_number": "972-898-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD",
            "address_2": "SUITE 103",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416399",
            "telephone_number": "314-469-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH KING",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003419",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009001275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyiah Johnson
• Mackenzie Johnson, MD
• Madisyn S Johnson
• Mark C Johnson, MD
• Marsha Rochelle Johnson, ACNP
• McKinzie Johnson
• Michael Johnson
• Michael Hiroshi Johnson, MD
• Michael K. Johnson, M.D.
• Monica Y Johnson, WHNP

• All providers in Saint Louis, MO
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.