Samuel A Johnson (NPI# 1225255128, PAC ID# 7214037373) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1225255128 |
| PAC ID by PECOS | 7214037373 |
| Professional Enrollment ID | I20120919000737 |
| Full Name | Samuel A Johnson |
| Organization Legal Name | PREFERRED VASCULAR SERVICES NORTHWEST LLC |
| Address |
1100 Lake Hearn Dr Suite 200 Atlanta GA 30342-1523 |
| Phone Number | 4044038310 |
| Gender | M |
| Medical School | TEMPLE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 1850552142 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110035 | WELLSTAR KENNESTONE HOSPITAL |
| 110008 | NORTHSIDE HOSPITAL CHEROKEE |
| 110143 | WELLSTAR COBB HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1 Dunwoody Park, Suite 140, Atlanta, GA 30338-6708 | 4045542080 | PREFERRED VASCULAR SERVICES NORTHEAST |
| 1100 Lake Hearn Dr, Suite 200, Atlanta, GA 30342-1523 | 4044038310 | PREFERRED VASCULAR SERVICES NORTHWEST LLC |
| 1100 Lake Hearn Dr, Suite 200, Atlanta, GA 30342-1573 | 4045542080 | PREFERRED VASCULAR SERVICES NORTHEAST |
| 55 Whitcher St, Suite 460, Marietta, GA 30060-1171 | 7704277389 | GEORGIA KIDNEY ASSOCIATES, INC. |
| 711 Canton Rd Ne, Suite 220, Marietta, GA 30060-8949 | 4045542196 | NORTHWEST ATLANTA VASCULAR CARE LLC |
| 790 Church St, Suite 510, Marietta, GA 30060-7282 | 4045542196 | NORTHWEST ATLANTA VASCULAR CARE LLC |
| Organization Legal Name | PREFERRED VASCULAR SERVICES NORTHWEST LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jay U Patel | Diagnostic Radiology | Preferred Vascular Services Northwest LLC | 889 2nd St, Macon, GA 31201-6862 |
| Paul Bernard Jones | Vascular Surgery | Preferred Vascular Services Northwest LLC | 5461 Hillandale Dr, Suite 210, Lithonia, GA 30058-4842 |
| James P Rielly | Vascular Surgery | Preferred Vascular Services Northwest LLC | 790 Church St, Suite 510, Marietta, GA 30060-7282 |
| John T Perry | Vascular Surgery | Preferred Vascular Services Northwest LLC | 790 Church St, Suite 510, Marietta, GA 30060-7282 |
| Street Address |
1100 LAKE HEARN DR SUITE 200 |
| City | ATLANTA |
| State | GA |
| Zip | 30342-1523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tabitha R Casey | Psychologist, Clinical | The Southeast Permanente Medical Group | 1100 Lake Hearn Dr, Sandy Springs, GA 30342-1523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerry T Todd | Anesthesiology | Mak Anesthesia Holdings, LLC | 9930 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342 |
| Nelson Enrique Castillo | Plastic and Reconstructive Surgery | 5445 Meridian Mark Rd Ne, Suite 395, Sandy Springs, GA 30342 | |
| Mackenzie J King | Nurse Practitioner | Northside Radiology Associates PC | 5445 Meridian Mark Rd, Suite 450, Atlanta, GA 30342 |
| Stephen Kraus | Emergency Medicine | Dermatology Associates of Atlanta | 5555 Peachtree Dnwdy Rd, Suite 190, Atlanta, GA 30342 |
| Charles F Peebles | Podiatry | Perry H Julien Dpm | 5600 Roswell Rd Ne, M190, Atlanta, GA 30342-1134 |
| Perry H Julien | Podiatry | Perry H Julien Dpm | 5600 Roswell Rd Ne, M190, Atlanta, GA 30342-1134 |
| Amanda Elizabeth Williams | Psychiatry | 5605 Glenridge Dr, Suite 620, Atlanta, GA 30342-1377 | |
| Daniel J Wachtel | Psychologist, Clinical | 5605 Glenridge Dr Ne, Suite 600, Atlanta, GA 30342-1377 | |
| James A Purvis | Psychologist, Clinical | 5605 Glenridge Dr, Suite 620, Atlanta, GA 30342-1377 | |
| Viviana L Mahoney | Psychologist, Clinical | 5605 Glenridge Dr, Suite 620, Atlanta, GA 30342-1377 | |
| Find all physicians in zip 30342 | |||
| City | ATLANTA |
| Zip Code | 30342 |
| Specialty | NEPHROLOGY |
| City + Specialty | ATLANTA + NEPHROLOGY |
Please comment or provide details below to improve the information on Samuel A Johnson.
| 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.