JESSICA MARIE JOHNSON (NPI# 1124540588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124540588 |
| Entity Type | Individual |
| Full Name | JESSICA MARIE JOHNSON |
| Credential | PA-C |
| Practice Address |
400 Health Park Blvd St Augustine FL 32086-5784 |
| Mailing Address |
1244 S Ocean Shore Blvd Flagler Beach FL 32136-3703 |
| Practice Telephone | 9045566152 |
| Mailing Telephone | 9045566152 |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
9110457 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1244 S Ocean Shore Blvd, Flagler Beach, FL 321363703 | (904) 556-6152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978039 | Jessica N Johnson | Pediatrics | 4078 Country Club Rd, Brodnax, VA 23920-3404 | 2020-10-08 |
| 1134747165 | Jessica Johnson | Registered Nurse | 535 Los Alamos Rd, Santa Rosa, CA 95409-4425 | 2020-07-07 |
| 1710504311 | Jessica Lee Johnson | Registered Nurse | 7373 W 6th Ave, Lakewood, CO 80214-4518 | 2020-06-30 |
| 1427670827 | Jessica Johnson | Registered Nurse | 745 Shaker Mill Rd, Bowling Green, KY 42103-9064 | 2020-05-08 |
| 1124649926 | Jessica Delores Johnson | Nurse Practitioner | 360 Ossie Davis Pkwy, Waycross, GA 31501-4566 | 2020-05-03 |
| 1467084806 | Jessica Lyn Johnson | Specialist/Technologist | 23 E 157th Pl S, Glenpool, OK 74033-4437 | 2020-02-04 |
| 1215588819 | Jessica Johnson | Counselor | 1001 John D Odom Rd, Dothan, AL 36303-9485 | 2019-09-25 |
| 1356905145 | Jessica Johnson | Technician | 2506 14th St Ne Apt 2, Washington, DC 20018-1928 | 2019-04-26 |
| 1043776503 | Jessica Johnson | Nurse Practitioner | 3303 Duval St, Jupiter, FL 33458-8259 | 2019-02-20 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| Street Address |
400 HEALTH PARK BLVD |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881818 | Emergency Physicians of St. Johns County | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2005-09-15 |
| 1245846468 | Nicole Marie Zisman | Internal Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-09-22 |
| 1700499522 | Yolanda Campbell | Family Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-08-31 |
| 1952912826 | Megan Burke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2020-08-13 |
| 1639709173 | Keith Latasiewicz | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-01-23 |
| 1508416991 | Ashley Jarriel Gucwa | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2019-09-17 |
| 1831741925 | Jessica Anne Lindamood | Dietitian, Registered | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2019-07-10 |
| 1649787326 | Spencer Jonathan Garrison | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2018-01-04 |
| 1750804662 | Gabrielle Du Sablon | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-23 |
| 1952838898 | Beau Brian Nacke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1871686352 | Phillip Alex Wimpelberg | Physician Assistant | 2720 Us Highway 1 S, Ste B, St Augustine, FL 32086-6301 | 2006-10-02 |
| 1457323834 | Eugene Kinnaly | Physician Assistant | 100 Arricola Ave, St Augustine, FL 32080-4515 | 2006-02-01 |
| 1639542673 | Jonathan Baron | Physician Assistant | 240 Southpark Cir E, St Augustine, FL 32086-5137 | 2015-11-12 |
| 1316268311 | David Robert Skaggs | Physician Assistant | 2460 Old Moultrie Rd Ste 5, St Augustine, FL 32086-4198 | 2010-06-14 |
| 1558540500 | Earnest E Kepler | Physician Assistant | 1 Orthopaedic Pl, St Augustine, FL 32086-4202 | 2007-10-26 |
| 1679690366 | Michael R Medved | Physician Assistant | 165 Southpark Blvd, St Augustine, FL 32086-4101 | 2007-03-26 |
| 1700921020 | Brooke Michelle Perussina | Physician Assistant | 103 Anastasia Blvd, St Augustine, FL 32080 | 2007-02-21 |
| 1306981378 | Randolph W Heath | Physician Assistant | 120 Health Park Blvd Ste 1, St Augustine, FL 32086-5798 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.