MR. JACK FRANK JOHNSON III (NPI# 1962638999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962638999 |
| Entity Type | Individual |
| Full Name | MR. JACK FRANK JOHNSON III |
| Other Name | MR. JAY JOHNSON III |
| Credential | APRN |
| Practice Address |
724 Arden Ln Suite 100 Rock Hill SC 29732-2996 |
| Practice Telephone | 8039807337 |
| Practice Fax Number | 8039802229 |
| Mailing Telephone | 8039807337 |
| Mailing Fax Number | 8039802229 |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2009-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
3360 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SOUTH CAROLINA CONTROLLED SUBSTANCES CERTIFICATE OF REGISTRATION | 54-03360 | 01 |
| SC | SOUTH CAROLINA STATE LICENSE | 3360 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
| 1881129419 | Jack Alston Johnson | Emergency Medicine | 2300 Lone Star Rd, Mansfield, TX 76063-8744 | 2017-04-20 |
| 1396063418 | Jack Simpson Johnson | General Practice | 979 Mt. Vernon Rd., Cookeville, TN 38501 | 2010-05-13 |
| 1295992030 | Jack Allen Johnson Jr. | Psychologist | 12469 Timberwood Dr, Walker, LA 70785-5743 | 2008-05-20 |
| 1548332570 | Jack W Johnson | Psychiatry & Neurology | 12377 Lewis Street, Suite #104, Garden Grove, CA 92840-4691 | 2006-11-14 |
| 1568570018 | Jack Lawrence Johnson | Marriage & Family Therapist | 3576 Arlington Ave, Suite 307, Riverside, CA 92506-3943 | 2006-08-25 |
| 1730699695 | Jack N Johnson | Naturopath | 5603 38th Ave Nw, Gig Harbor, WA 98335-8218 | 2017-10-05 |
| 1902912322 | Jack F Johnson Jr. | Ophthalmology | 1190 Summers Ave, Orangeburg, SC 29115-4922 | 2006-08-21 |
| 1801859996 | Jack Leegon Johnson Jr. | Family Medicine | 560 W Main St, Suite 100, Lewisville, TX 75057-3629 | 2006-04-10 |
| 1356316996 | Jack Johnson | Anesthesiology | 455 Sherman St, Ste 510, Denver, CO 80203-4400 | 2006-02-17 |
| Street Address |
724 ARDEN LN SUITE 100 |
| City | ROCK HILL |
| State | SC |
| Zip Code | 29732-2996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932192481 | Rajeshkumar M. Patel | Pediatrics | 724 Arden Ln, Suite 100, Rock Hill, SC 29732-2984 | 2005-08-30 |
| 1720256522 | Katherine Fisher | Nurse Practitioner | 724 Arden Ln, Suite 100, Rock Hill, SC 29732-2996 | 2008-02-14 |
| 1548484439 | Piedmont Podiatry Group | Podiatrist | 724 Arden Ln, Suite 200, Rock Hill, SC 29732-3257 | 2007-04-12 |
| 1629169693 | Sunshine Pediatrics | Pediatrics | 724 Arden Ln, Suite 100, Rock Hill, SC 29732-2996 | 2006-09-27 |
| 1851305031 | Carlos G Paxtor | Pediatrics | 724 Arden Ln, Suite 100, Rock Hill, SC 29732-2996 | 2006-07-27 |
| 1417932559 | Lee J Raykovicz | Optometrist | 724 Arden Ln, Suite 120, Rock Hill, SC 29732-2996 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659471 | Jessie M. Armstrong | Counselor | 199 S Herlong Avenue, Rock Hill, SC 29732 | 2019-10-07 |
| 1215407861 | Alicia Johnson | Occupational Therapist | 2025 Ebenezer Rd Suite H, Rock Hill, SC 29732 | 2018-11-27 |
| 1346716909 | Leslie Marie Metzler | Nurse Practitioner | 125 Amendment Ave, Rock Hill, SC 29732 | 2018-10-22 |
| 1356824668 | Laurie E Grove | Counselor | 508 Bethel Street, Clover, SC 29732 | 2018-09-12 |
| 1366924441 | Chinyere Gill-smith | Occupational Therapist | 2390 127 Murrah Drive, Rock Hill, SC 29732 | 2018-09-05 |
| 1053825513 | Community Medicine Foundation Inc | Clinic/Center | 205 Piedmont Blvd. Suite 100, Catawba Community Mental Health Services York Adult Ser, Rock Hill, SC 29732 | 2017-11-20 |
| 1952824906 | Miriam George-norman | Occupational Therapist | 831 Mcdow Drive, Rock Hill, SC 29732 | 2017-07-21 |
| 1255854550 | Courtney Costa | Counselor | 199 S. Herlong Avenue, Rock Hill, NC 29732 | 2017-07-19 |
| 1861913022 | Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa | Oral & Maxillofacial Surgery | 1761 Ebenezer Road, Rock Hill, SC 29732 | 2017-06-28 |
| 1396275806 | Chrysalis Autism Center, Inc | Assistant Behavior Analyst | 1547 Cherry Rd, Rock Hill, SC 29732 | 2017-06-16 |
| Find all providers in zip 29732 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114970712 | Phyllis C Poyner | Clinical Nurse Specialist | 1410 Blanding St Ste 102, Columbia, SC 29201-2967 | 2006-05-18 |
| 1639422892 | The Clinic | Clinical Nurse Specialist | 157 William Hilton Pkwy, Hilton Head Island, SC 29926-5218 | 2012-10-24 |
| 1316275068 | Wendy Schmunk | Clinical Nurse Specialist | 101 Springhall Dr, Goose Creek, SC 29445-5336 | 2009-11-18 |
Please comment or provide details below to improve the information on MR. JACK FRANK JOHNSON III.
| 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.