DENETRA JOHNSON
NPI 1205207388
Nurse Practitioner - Family in Stockbridge, GA
About Denetra Johnson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DENETRA JOHNSON (NPI 1205207388) is an individual family provider in Stockbridge, Georgia, licensed in Georgia (RN161105) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Denetra Johnson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
10Medicare enrollment records show Denetra Johnson reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Riverdale, GA 30274
- Reassigned Medicare billing, Georgia enrollment
- Medicare enrollment name: Georgia Em-I Medical Services, LLC
- 132 clinicians in this Medicare group
Conyers, GA 30012
- Reassigned Medicare billing, Georgia enrollment
- 85 clinicians in this Medicare group
Austell, GA 30106
- Reassigned Medicare billing, Georgia enrollment
- 353 clinicians in this Medicare group
Monroe, GA 30655
- Reassigned Medicare billing, Georgia enrollment
- 777 clinicians in this Medicare group
Columbus, GA 31904
- Reassigned Medicare billing, Georgia enrollment
- 200 clinicians in this Medicare group
Newport, TN 37821
- Reassigned Medicare billing, Georgia enrollment
- 330 clinicians in this Medicare group
Myrtle Beach, SC 29572
- Reassigned Medicare billing, Georgia enrollment
- 586 clinicians in this Medicare group
Clewiston, FL 33440
- Reassigned Medicare billing, Georgia enrollment
- 65 clinicians in this Medicare group
Rockville, MD 20854
- Reassigned Medicare billing, Georgia enrollment
- 350 clinicians in this Medicare group
Spring, TX 77373
- Reassigned Medicare billing, Georgia enrollment
- 113 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30281 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Denetra Johnson's NPI number?
The NPI number for Denetra Johnson is 1205207388. It was assigned to this individual provider in the NPPES registry on October 14, 2015.
Where is Denetra Johnson located?
Denetra Johnson practices at 5095 Mount Zion Pkwy, Stockbridge, GA 30281. The listed phone number is (401) 652-9787.
What is Denetra Johnson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Denetra Johnson enrolled in Medicare?
Yes. Denetra Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Denetra Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Denetra Johnson reassigns Medicare benefits to 10 organizations: Georgia Em-I Medical Service PC (Riverdale, GA), Walker Lake Emergency Group, PC (Conyers, GA), The Bortolazzo Group, LLC (Austell, GA), Hospital Physician Services - Southeast Professional Corporation (Monroe, GA), Inphynet Primary Care Physicians Southeast PC (Columbus, GA) and 5 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Denetra Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Denetra Johnson accept?
Health plans from CareSource, CareSource (Common Ground Healthcare) and Oscar Insurance Company list Denetra Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Denetra Johnson was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Denetra Johnson · NPI 1205207388
Family physician in Stockbridge, Georgia. Individual provider, active in the CMS NPPES registry since October 14, 2015.
## Identity
- **NPI:** 1205207388 (Entity type: Individual)
- **Enumerated:** October 14, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN161105 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 5095 MOUNT ZION PKWY, Stockbridge, GA 30281-7825
- **Phone:** (401) 652-9787 · **Fax:** (401) 652-9787
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 10 organizations under Medicare reassignment (form CMS-855R): Georgia Em-I Medical Service PC (NPI 1639796212, Riverdale, GA); Walker Lake Emergency Group, PC (NPI 1437629342, Conyers, GA); The Bortolazzo Group, LLC (NPI 1801965082, Austell, GA); Hospital Physician Services - Southeast Professional Corporation (NPI 1760410385, Monroe, GA); Inphynet Primary Care Physicians Southeast PC (NPI 1770521460, Columbus, GA); and 5 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** October 10, 2025
- **Other identifiers:** Other RN161105 (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1205207388) · Data from the CMS NPPES public registry.