1. Home
  2. Directory
  3. West Virginia
  4. South Charleston
  5. Physician Assistant
  6. NPI Profile

GARY LYNN JOHNSON PA
NPI 1336116003
Physician Assistant in South Charleston, WV

Active since March 02, 2006PECOS Enrolled
610 CHESTNUT ST, SOUTH CHARLESTON, WV 25309(304) 766-7515(304) 766-7566 Get Directions Write a Review

NPPES record last updated: December 17, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gary Lynn Johnson Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY LYNN JOHNSON PA (NPI 1336116003) is an individual physician assistant in South Charleston, West Virginia, licensed in West Virginia (01092) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336116003
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGARY LYNN JOHNSONCredential: PA
Location Address610 CHESTNUT STSouth Charleston, WV 25309-1251
Mailing Address107 Rocky Step RdScott Depot, WV 25560-9631 · (304) 412-4243
Phone(304) 766-7515
Fax(304) 766-7566
Sole ProprietorNo
Enumeration DateMarch 2, 2006
Last NPPES UpdateDecember 17, 2007
✔ NPI 1336116003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WV · 01092
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
610 CHESTNUT ST, South Charleston, WV 25309
Open in Google Maps ↗

Other Identifiers 5

Other1071247WV · Wv Dwc
Medicare PINP00387974WV
Other01092WV · License
Medicare ID-Type UnspecifiedJOPA23451WV
Medicare PINJOPA23452WV

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Lynn Johnson Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25309 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRUCE FREDRIC HAUPT MD
Orthopaedic Surgery
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515
DR. FREDDIE DOMINICK PERSINGER D.O.
Orthopaedic Surgery
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515
ORTHOCLINIC
Specialist
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515
HERBERT J THOMAS MEMORIAL HOSPITAL ASSOCIATION
Orthopaedic Surgery
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 767-7790
DAVID LEON SOULSBY M.D.
Orthopaedic Surgery
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515
JUSTIN KIEL MEDLIN PA-C
Physician Assistant (Surgical)
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515
DR. JEREMY ANDREW CALDERWOOD DO
Family Medicine (Sports Medicine)
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 767-7790
MATTHEW DAVID STOVER D.O.
Orthopaedic Surgery
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309
Kanawha County (304) 766-7515

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 Gary Johnson's NPI number?

The NPI number for Gary Johnson is 1336116003. It was assigned to this individual provider in the NPPES registry on March 2, 2006.

Where is Gary Johnson located?

Gary Johnson practices at 610 Chestnut St, South Charleston, WV 25309. The listed phone number is (304) 766-7515.

What is Gary Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Gary Johnson enrolled in Medicare?

Yes. Gary Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Johnson was last updated on December 17, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.