MRS. JENNIFER PATRICIA JOHNSON, PA-C - NPI NUMBER 1740478981

Summary

Provider Name: MRS. JENNIFER PATRICIA JOHNSON, PA-C

NPI Number: 1740478981

Clasification: Physician Assistant (363A00000X)

Address:
550 WELLS RD
SUITE 17
ORANGE PARK, FL
ZIP 32073

Phone Number: (904) 269-2900



Detailed Information

MRS. Jennifer Patricia Johnson, PA-C is a physician assistant in Orange Park, FL. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. The assigned NPI number for this provider is 1740478981 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

550 WELLS RD
SUITE 17
ORANGE PARK, FL
ZIP 32073-969
Phone: (904) 269-2900
Fax: (904) 269-1140

The enumeration date for this NPI number is 10/12/2007 and was last updated on 7/9/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363A00000X Physician Assistant PAT9104376 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 P01207952 OTHER FL RAILROAD MEDICARE
2 AF880X MEDICARE PIN FL
3 292932500 MEDICAID FL

NPI Record

No. Field Name Field Value
1 NPI 1740478981
2 Entity Type Code 1
3 Provider Last Name Legal Name JOHNSON
4 Provider First Name JENNIFER
5 Provider Middle Name PATRICIA
6 Provider Name Prefix Text MRS.
7 Provider Credential Text PA-C
8 Provider Other Last Name TOZZI
9 Provider Other First Name JENNIFER
10 Provider Other Middle Name PATRICIA
11 Provider Other Name Prefix Text MS.
12 Provider Other Credential Text PA-C
13 Provider Other Last Name Type Code 1
14 Provider First Line Business Practice Location Address 550 WELLS RD
15 Provider Second Line Business Practice Location Address SUITE 17
16 Provider Business Practice Location Address City Name ORANGE PARK
17 Provider Business Practice Location Address State Name FL
18 Provider Business Practice Location Address Postal Code 320732969
19 Provider Business Practice Location Address Country Code If outside U S US
20 Provider Business Practice Location Address Telephone Number 9042692900
21 Provider Business Practice Location Address Fax Number 9042691140
22 Provider Enumeration Date 10/12/2007
23 Last Update Date 7/9/2014
24 Provider Gender Code F
25 Healthcare Provider Taxonomy Code 1 363A00000X
26 Provider License Number 1 PAT9104376
27 Provider License Number State Code 1 FL
28 Healthcare Provider Primary Taxonomy Switch 1 Y
29 Other Provider Identifier 1 P01207952
30 Other Provider Identifier Type Code 1 01
31 Other Provider Identifier State 1 FL
32 Other Provider Identifier Issuer 1 RAILROAD MEDICARE
33 Other Provider Identifier 2 AF880X
34 Other Provider Identifier Type Code 2 08
35 Other Provider Identifier State 2 FL
36 Other Provider Identifier 3 292932500
37 Other Provider Identifier Type Code 3 05
38 Other Provider Identifier State 3 FL
39 Is Sole Proprietor N

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.