MR. KENNETH RAY JOHNSON PA-C
NPI 1962784785
Physician Assistant - Surgical in Evans, GA

Active since September 19, 2011PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1203 TOWN PARK LN, EVANS, GA 30809(706) 650-7546(706) 922-9168 Get Directions Write a Review

NPPES record last updated: June 29, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Kenneth Ray Johnson Pa-c NPPES

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

MR. KENNETH RAY JOHNSON PA-C (NPI 1962784785) is an individual surgical provider in Evans, Georgia, licensed in Georgia (6259) and active in the NPI registry since September 2011. He is enrolled in Medicare PECOS, is affiliated with Piedmont Augusta Hospital, and is a graduate of Medical College Of Georgia School Of Medicine (2011).

NPPES Registry Identity

NPI1962784785
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. KENNETH RAY JOHNSONCredential: PA-C
Location Address1203 TOWN PARK LNEvans, GA 30809
Mailing AddressPo Box 63185Charlotte, NC 28263-3001 · (706) 650-7546 · Fax (706) 922-9168
Fax(706) 922-9168
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2011
Enumeration DateSeptember 19, 2011
Last NPPES UpdateJune 29, 2018
NPI 1962784785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in GA · 6259
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 6259 (GA)
1203 TOWN PARK LN, Evans, GA 30809

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Kenneth Ray Johnson Pa-c 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.

PECOS PAC ID9335311000
PECOS Enrollment IDI20111003000250
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.

Areas of Expertise CMS Part B claims 29

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.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
4,247 services585 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,416 services936 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
1,261 services946 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,227 services904 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
841 services678 patients
Biopsy of related skin growth, each additional growth 11103
A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.
782 services426 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Augusta Hospital

Acute Care Hospitals · Augusta, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110028
Location1350 Walton WayAugusta, GA 30901 · Richmond County
Emergency services Birthing friendly

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

Dermatology (MOHS-Micrographic Surgery)
1203 TOWN PARK LN
EVANS, GA 30809
Dermatology
1203 TOWN PARK LN
EVANS, GA 30809
Physician Assistant
1203 TOWN PARK LN
EVANS, GA 30809

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 Kenneth Johnson's NPI number?

The NPI number for Kenneth Johnson is 1962784785. It was assigned to this individual provider in the NPPES registry on September 19, 2011.

Where is Kenneth Johnson located?

Kenneth Johnson practices at 1203 Town Park Ln, Evans, GA 30809. The listed phone number is (706) 650-7546.

What is Kenneth Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kenneth Johnson enrolled in Medicare?

Yes. Kenneth 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.

Is Kenneth Johnson affiliated with any hospitals?

According to CMS data, Kenneth Johnson is affiliated with Piedmont Augusta Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Johnson was last updated on June 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.