Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1104893130 Deactivated / Inactive NPI Male Practitioner

Wilbur Lavern Johnson , PA-C

Physician Assistant • Yulee, FL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Wilbur Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 08, 2006
NPI Deactivation Date August 05, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Wilbur Johnson, PA-C was a registered Physician Assistant practicing in Yulee, FL. Throughout an active medical career spanning 16 years, Wilbur Johnson provided care at the practice location at 851042 US HIGHWAY 17 until profile deactivation on 2022-08-05.

Practice Location & Contact Primary Location

Practice Address

851042 Us Highway 17
Ufjp Yulee Family Practice Center

Yulee, FL 320972845

Telephone 9042259043
Fax 9042259491
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Yulee, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.0 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
5 Specialists

Practicing in Yulee, FL (10376 Statewide)

Telehealth Adoption Rate
20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA1720

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Jimmie Stone , PA-C

Physician Assistant - Medical

NPI 1023076098

Physician Assistant (Certified)

Michelle Pendleton , APRN

Nurse Practitioner

NPI 1134596802

Advanced Practice Registered Nurse

Dr. John Pinkston , MD

Internal Medicine

NPI 1194701391

Doctor of Medicine (M.D.)

NPI 1235190646

Doctor of Medicine (M.D.)

Megan Day , PA

Physician Assistant

NPI 1447482898

Physician Assistant

NPI 1467742957

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated August 05, 2022

Record deactivated on August 05, 2022

NPI Profile Active August 20, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location August 20, 2008

Registered at 851042 US HIGHWAY 17, UFJP YULEE FAMILY PRACTICE CENTER, YULEE, FL 320972845 (Tel: 9042259043)

📍
Updated Business Mailing Address August 20, 2008

Registered at PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 322314008 (Tel: 9042443199)

👤
Provider Name / Credentials Updated August 20, 2008

Recorded as WILBUR JOHNSON, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 20, 2008

Physician Assistant (License #PA1720 in FL)

🟢
Initial NPI Registration & Enumeration March 08, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Wilbur Johnson. Be the first to share your experience!

Sign in to leave a review for Wilbur Johnson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1104893130
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 08, 2006
Last Update: August 20, 2008
Deactivation Date: August 05, 2022

Mailing Address

Po Box 44008, Ufjp Provider Enrollment

Jacksonville, FL 322314008

Phone: 9042443199

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.