Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaddijatou Sanyang Johnson, PA-C, MMS

Individual provider Physician Assistant · NPI 1356739015

Kaddijatou Sanyang Johnson, PA-C, MMS is a Physician Assistant in Raleigh, North Carolina. Qualified in 2014, 12 years ago. Practices with UNC Physicians Network LLC, a 986-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
12
Licensed in
NC
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10208 Cerny St Ste 110
Raleigh, NC 27617-7885
Phone: (984) 215-4590
Fax: (984) 215-4591
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1500 Garner Rd, Raleigh, NC 27610 — (919) 556-1008

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-05462 (NC)

Record details

NPI number1356739015
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MMS
Sole proprietorNo
NPI enumeratedJanuary 5, 2015
Last updated in NPPESSeptember 15, 2023
Certification dateSeptember 15, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Unc Physicians Network Llc — 986 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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