Denetra Johnson, - Medicare Nurse Practitioner in Stockbridge, GA

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Denetra Johnson, is a medicare enrolled "Nurse Practitioner - Family" in Stockbridge, Georgia. She graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Acs Primary Care Physicians - Southeast Pc, Minuteclinic Llc and her current practice location is 5095 Mount Zion Pkwy, Stockbridge, Georgia. You can reach out to her office (for appointments etc.) via phone at (401) 652-9787.

Denetra Johnson is licensed to practice in Georgia (license number RN161105) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1205207388.

Contact Information

Denetra Johnson,
5095 Mount Zion Pkwy,
Stockbridge, GA 30281-7825
(401) 652-9787
(401) 652-9787

Map and Direction




Provider's Profile

Full NameDenetra Johnson
GenderFemale
SpecialityNurse Practitioner
Experience12 Years
Location5095 Mount Zion Pkwy, Stockbridge, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Denetra Johnson graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1205207388
  • Provider Enumeration Date: 10/14/2015
  • Last Update Date: 10/10/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7113216987
  • Enrollment ID: I20160518000279

Medical Identifiers

Medical identifiers for Denetra Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205207388NPI-NPPES
RN161105OtherGALICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family R865978 (Mississippi)Secondary
363LF0000XNurse Practitioner - Family RN161105 (Georgia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Acs Primary Care Physicians - Southeast Pc5193620714409
Minuteclinic Llc6709850241576

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Denetra Johnson allows following entities to bill medicare on her behalf.
Entity NameInphynet Primary Care Physicians Southeast PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770521460
PECOS PAC ID: 3779497045
Enrollment ID: O20031119000600
Entity NameGeorgia Em-i Medical Services PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851569560
PECOS PAC ID: 0446157218
Enrollment ID: O20031218000621
Entity NameAcs Primary Care Physicians - Southeast PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861430555
PECOS PAC ID: 5193620714
Enrollment ID: O20040901000766
Entity NameEmergency Coverage LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427005008
PECOS PAC ID: 3072412592
Enrollment ID: O20050411000056
Entity NameMinuteclinic LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134191836
PECOS PAC ID: 6709850241
Enrollment ID: O20051024000186
Entity NameHospital Physician Services - Southeast Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760410385
PECOS PAC ID: 5597774554
Enrollment ID: O20060419000545
Entity NameThe Bortolazzo Group, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801965082
PECOS PAC ID: 3476554320
Enrollment ID: O20070122000015
Entity NameWalker Lake Emergency Group PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437629342
PECOS PAC ID: 0840531919
Enrollment ID: O20190418001186
Entity NameSmall Hospital Innovations LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184040560
PECOS PAC ID: 0840415444
Enrollment ID: O20220404000661
Entity NamePrimary Care PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770354763
PECOS PAC ID: 0941642169
Enrollment ID: O20241106000482

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Denetra Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Denetra Johnson,
5095 Mount Zion Pkwy,
Stockbridge, GA 30281-7825

Ph: Not Available		Denetra Johnson,
5095 Mount Zion Pkwy,
Stockbridge, GA 30281-7825

Ph: (401) 652-9787

Reviews and Comments


Nurse Practitioner Nurses in Stockbridge, GA

Casey R. Black, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 125 Eagle Spring Dr, Stockbridge, GA 30281
Phone: 770-213-3366    Fax: 404-962-6943
Ms. Rita Raynel Givens, FNP-BC
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 830 Eagles Landing Pkwy Ste 204, Stockbridge, GA 30281
Phone: 770-962-3642    Fax: 770-962-3643
Ms. Eleasha R Gray, C-FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 165 North Park Trail, Stockbridge, GA 30281
Phone: 770-506-1800    Fax: 770-389-5947
Jeanine Clark, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 175 Medical Blvd, Stockbridge, GA 30281
Phone: 239-443-8018    
Sandra Thomas,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 950 Eagles Landing Pkwy # 210, Stockbridge, GA 30281
Phone: 770-668-3363    
Shanea R Mcdaniel, RN, PMHNP-BC
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 552 Creek Valley Ct, Stockbridge, GA 30281
Phone: 803-617-9953    
Stacie Lynn Ricketts-mccook, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1133 Eagles Landing Pkwy, Stockbridge, GA 30281
Phone: 678-604-5901    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.