TAIRY ADAMS JOHNSON (P.A.-C) – Physician Assistant, NPI 1063468890

TAIRY ADAMS JOHNSON (P.A.-C) is a healthcare provider. based in Woodbridge, Virginia. specializing in Physician Assistant. They hold the professional credentials P.A.-C. They hold a License No. 0110001991 (VA). The NPI Number for TAIRY ADAMS JOHNSON (P.A.-C) is 1063468890

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
TAIRY ADAMS JOHNSON (P.A.-C)
NPI
1063468890
Phone
(703) 523-1504
Address
2300 OPITZ BLVD
Enumeration Date
25 May 2006
Last Update Date
4 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7035231504
Graduation Year
2004 (22 years ago)
PAC ID
6901858349
Group Practice PAC ID
8729218938
Professional Enrollment ID
I20050215000095
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for TAIRY ADAMS JOHNSON (P.A.-C)

  • 2300 OPITZ BLVD

    WOODBRIDGE, VA 221913311

    Phone: (703) 523-1504

    Type: Mailing

  • 4431, Starkey Road, Beulah Heights, Cave Spring, Roanoke County, Virginia, 24018, United States

    ROANOKE, VA 240180612

    Phone: (540) 342-0211

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050215000095IPhysician AssistantVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making4036$0
99285Emergency department visit with high level of medical decision making2121$0
99283Emergency department visit with low level of medical decision making1712$0
View full utilization report →

Insurance plans in this area (ZIP 22191)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729218938View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm TAIRY ADAMS JOHNSON (P.A.-C)'s NPI?
Yes. TAIRY ADAMS JOHNSON (P.A.-C) is listed with NPI 1063468890 in the public NPI dataset.
Can I rely on TAIRY ADAMS JOHNSON (P.A.-C) being an active provider?
As of the registry snapshot, TAIRY ADAMS JOHNSON (P.A.-C) is marked active.
What is TAIRY ADAMS JOHNSON (P.A.-C)'s specialty?
The listing groups TAIRY ADAMS JOHNSON (P.A.-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Does TAIRY ADAMS JOHNSON (P.A.-C) list a practice location?
Patients near Woodbridge, Virginia may find TAIRY ADAMS JOHNSON (P.A.-C) in results; validate coverage separately.
Why does TAIRY ADAMS JOHNSON (P.A.-C) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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