Carl Johnson Iii (NPI# 1023018561, PAC ID# 4688869704) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1023018561 |
| PAC ID by PECOS | 4688869704 |
| Professional Enrollment ID | I20101115000206 |
| Full Name | Carl Johnson Iii |
| Organization Legal Name | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Address |
101 Yorktown Dr Suite 100 Fayetteville GA 30214-7663 |
| Phone Number | 7704604285 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | GENERAL PRACTICE |
| Group Practice PAC ID | 4284951542 |
| Number of Group Practice Members | 215 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110095 | TIFT REGIONAL MEDICAL CENTER |
| 110101 | COOK MEDICAL CENTER A CAMPUS OF TIFT REG MED CTR |
| Address | Phone | Organization |
|---|---|---|
| 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 | 7704604285 | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| 612 Love Ave, Tifton, GA 31794-4406 | 2293913300 | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 88% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 51% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 4% | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 98% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 2% |
| Organization Legal Name | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Physicians | 225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Deason Perritt | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1218 Alice St, Waycross, GA 31501-4525 |
| Angela Duke | Nurse Practitioner | Privia Medical Group of Georgia LLC | 106 Pilgrim Village Dr, Suite 400, Cumming, GA 30040-9242 |
| Daniel John Callahan | Physician Assistant | Privia Medical Group of Georgia LLC | 100 Genevieve Ct, Suite A, Peachtree City, GA 30269-4868 |
| Holly M Loesch | Obstetrics/gynecology | Privia Medical Group of Georgia LLC | 440 Washington St Se, Gainesville, GA 30501-3619 |
| Lyudmila P Carter | Internal Medicine | Privia Medical Group of Georgia LLC | 109 W Oglethorpe Hwy, Hinesville, GA 31313-3657 |
| Michaela Seward Jones | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1010 E Fwy Dr Se, Conyers, GA 30094-5965 |
| Erin Wells Raser | Physician Assistant | Privia Medical Group of Georgia LLC | 4000 Shakerag Hl, Suite 301, Peachtree City, GA 30269-4047 |
| Morgan Charlotte Jackson | Nurse Practitioner | Privia Medical Group of Georgia LLC | 119 W Hill St, Thomasville, GA 31792-6618 |
| Ashley Paige Keen | Nurse Practitioner | Privia Medical Group of Georgia LLC | 2402 Osler Ct, Albany, GA 31707-0205 |
| Jeanette Dormio | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1655 Lebanon Rd, Suite A, Lawrenceville, GA 30043-5116 |
| Street Address |
101 YORKTOWN DR SUITE 100 |
| City | FAYETTEVILLE |
| State | GA |
| Zip | 30214-7663 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marie Easterlin | Obstetrics/gynecology | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Christine A Swords | Nurse Practitioner | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Kacie Charlene Johnson | Nurse Practitioner | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Patrice Janice Wilson | Nurse Practitioner | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Gerald A Slagel | Dermatology | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Adrienne M Lynch | Physician Assistant | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Sandra Wordlaw-watkins | Family Medicine | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Randy B Cronic | Family Medicine | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Theodore Geffen | Family Medicine | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Micah D Riegner | Pediatric Medicine | Privia Medical Group of Georgia LLC | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-7663 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan Massey | Nurse Practitioner | Piedmont Providers LLC | 1279 Hwy 54 W, Suite 100, Fayetteville, GA 30214 |
| Connie T Dupre | Internal Medicine | Piedmont Medical Care Corporation | 1267 W Hwy 54, Suite 5200, Fayetteville, GA 30214 |
| Gregory Valentine | Family Medicine | 874 Lanier W Ave, Suite 210, Fayetteville, GA 30214 | |
| Byron F Harper | Internal Medicine | 106 Governors Square Prkwy, Fayetteville, GA 30214 | |
| Kayona Jones Moreland | Nurse Practitioner | Piedmont Cardiology of Atlanta, LLC | 1267 Hwy 54 W, Suite 2100, Fayetteville, GA 30214 |
| Paul Constantine Karagiannis | Cardiovascular Disease (cardiology) | Piedmont Cardiology of Atlanta, LLC | 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214 |
| Kevin Yang | Urology | Georgia Urology, Pa | 1336 Hwy 54 W, Fayetteville, GA 30214 |
| Angela R Parker | Nurse Practitioner | Piedmont Cardiology of Atlanta, LLC | 1267 Hwy 54 W, Suite 2100, Fayetteville, GA 30214 |
| Kavita Perumal Krishnasamy | Cardiac Electrophysiology | Piedmont Cardiology of Atlanta, LLC | 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214 |
| Rani Shah | Cardiovascular Disease (cardiology) | Piedmont Cardiology of Atlanta, LLC | 1267 Hwy 54 W, Suite 2200, Fayetteville, GA 30214 |
| Find all physicians in zip 30214 | |||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FAYETTEVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Carl Johnson Iii.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.