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MR. KENNETH RAY JOHNSON PA-C NPI 1962784785


NPI Information

NPI: 1962784785
Provider Name: MR. KENNETH RAY JOHNSON, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
1203 TOWN PARK LN
EVANS, GA
ZIP 30809
Phone: (706) 650-7546
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MR. Kenneth Ray Johnson, PA-C is a surgical physician assistant in Evans, GA with 13 years of experience. MR. Kenneth Ray Johnson, PA-C NPI is 1962784785. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

1203 TOWN PARK LN
EVANS, GA
ZIP 30809
Phone: (706) 650-7546
Fax: (706) 922-9168

The NPI 1962784785 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Tangential biopsy of single skin lesion (HCPCS:11102)
  • Destruction of skin growth (HCPCS:17000)
  • Tangential biopsy of additional skin lesion (HCPCS:11103)
  • Destruction of up to 14 skin growths (HCPCS:17110)

The enumeration date for this NPI number is 9/19/2011 and was last updated on 6/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1363AM0700XPhysician AssistantMedical6259GEORGIANo
2363AS0400XPhysician AssistantSurgical6259GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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.