GLEN F JOHNSON PA
NPI 1619971561
Physician Assistant in Fayetteville, NC

Active since June 09, 2005
524 BEAUMONT RD, FAYETTEVILLE, NC 28304(800) 476-8646 Get Directions Write a Review

NPPES record last updated: February 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Glen F Johnson Pa NPPES

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

GLEN F JOHNSON PA (NPI 1619971561) is an individual physician assistant in Fayetteville, North Carolina, licensed in North Carolina (00010366) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1619971561
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGLEN F JOHNSONCredential: PA
Location Address524 BEAUMONT RDFayetteville, NC 28304-4443
Mailing AddressPo Box 1070Charlotte, NC 28201-1070 · (800) 476-8646 · Fax (919) 382-3210
Sole ProprietorNo
Enumeration DateJune 9, 2005
Last NPPES UpdateFebruary 13, 2008
NPI 1619971561 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 NC · 00010366
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.
524 BEAUMONT RD, Fayetteville, NC 28304

Other Identifiers 4

Medicare PIN2759010ENC
Medicare UPINS19524NC
Medicare PIN2759010CNC
OtherP00390009NC · Railroad Medicare

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 Glen Johnson's NPI number?

The NPI number for Glen Johnson is 1619971561. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Glen Johnson located?

Glen Johnson practices at 524 Beaumont Rd, Fayetteville, NC 28304. The listed phone number is (800) 476-8646.

What is Glen Johnson's specialty?

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

When was this NPI record last updated?

The NPPES record for Glen Johnson was last updated on February 13, 2008. 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.