NPI age
17 years
Enumerated 2008-06-02
● Active
Type 1 · Individual
MR. Clyde D Johnson JR., CSA
Johnson is 1 of 128 physician assistant providers in Atlanta and 1 of 640 in Georgia.
Primary specialty
Physician Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2017-09-22
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 640 active physician assistant providers in Georgia.
NPI age
17 years
↑ 4 yr above median (13 yr)
State licenses
1 state
10% of peers hold multiple states
Subspecialties
0
37% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-06Enumerated in NPPES
2008
2026
Where they practice
Practice location
5881 Glendrige Dr Ne, Suite 120
Atlanta, GA 30328
Mailing address
5881 Glendrige Dr Ne, Suite 120
Atlanta, GA 30328
Specialties
-
Physician Assistant PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 359555800 | DEPT OF LABOR |
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.