MR. CLYDE D JOHNSON JR. (NPI# 1821256223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821256223 |
Entity Type | Individual |
Full Name | MR. CLYDE D JOHNSON JR. |
Credential | CSA |
Practice Address |
5881 Glendrige Dr Ne Suite 120 Atlanta GA 30328 |
Practice Telephone | 4043037703 |
Mailing Telephone | 4043037703 |
Enumeration Date | 2008-06-02 |
Last Update Date | 2017-09-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2625-2 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | DEPT OF LABOR | 359555800 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447749056 | Clyde Johnson IIi | Community/Behavioral Health | 2525 Tiller Lane Ste 110, Columbus, OH 43231 | 2018-05-09 |
1063766723 | Clyde Francis Johnson | Chiropractor | 7940 S University Blvd, Ste 100, Centennial, CO 80122-5104 | 2012-11-02 |
1568767317 | Clyde Johnson | Counselor | 930 N 14th St, New Castle, IN 47362-4311 | 2011-01-25 |
1962579375 | Clyde W Johnson | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004 | 2006-11-29 |
1124007851 | Clyde L. Johnson Jr. | Surgery | 1051 Johnston Willis Dr., St. 200, Richmond, VA 23235 | 2006-01-11 |
Street Address |
5881 GLENDRIGE DR NE SUITE 120 |
City | ATLANTA |
State | GA |
Zip Code | 30328 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
Find all providers in zip 30328 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912356775 | Jason Weddington | Physician Assistant | 5667 Peachtree Dunwoody Rd Ste 220, Atlanta, GA 30342-1725 | 2016-06-11 |
1578937181 | Vds Surgical Assistants, Inc. | Physician Assistant | 1307 W Garmon Rd, Atlanta, GA 30327-4405 | 2015-11-19 |
1407220379 | Simpson Surgery Group, LLC | Physician Assistant | 701 Highland Ave Ne Apt 1407, #1407, Atlanta, GA 30312-1454 | 2015-11-16 |
1417388232 | Tracey Lorena Tello | Physician Assistant | 931 Monroe Drive Ne, Suite 102 #641, Atlanta, GA 30308-7132 | 2013-12-04 |
1336587401 | Marissa B Highnote | Physician Assistant | 6045 Barfield Rd Ste 100, Atlanta, GA 30328-4402 | 2013-06-11 |
1396013223 | Signature Surgical Assistants | Physician Assistant | 2489 Kings Arms Dr Ne, Atlanta, GA 30345-2132 | 2011-12-07 |
1720364318 | Leah Strickland | Physician Assistant | 4279 Roswell Road Suite 102 Pmb 303, Atlanta, GA 30342 | 2011-10-26 |
1669798872 | Tiffiany Mccune | Physician Assistant | 4979 Lower Elm St, Atlanta, GA 30349-1677 | 2010-04-13 |
1306177233 | Hong Feng Shi | Physician Assistant | 4355 Cobb Pkwy Ste J131, Atlanta, GA 30339-3887 | 2010-01-15 |
1043408438 | Samuel Marion | Physician Assistant | 5881 Glenridge Dr Ste 120, Atlanta, GA 30328-8184 | 2007-10-10 |
Find all providers in ATLANTA |
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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.