NPIMap

Individual provider Active NPI

Taylor Derek Johnson, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1003494477
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD490907 Issued in PA
Practice address
2001 Vail Ave
Charlotte, NC 28207-1219
Phone
(704) 304-5000
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2026-02696 NC
Anesthesiology Physician 207L00000X MD490907 PA Primary

Addresses

Primary practice location

2001 Vail Ave
Charlotte, NC 28207-1219

Mailing address

6135 Park South Dr Ste 510
Charlotte, NC 28210-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251013000194 PA Practitioner - Anesthesiology 9335543750 Reassigns benefits to 2 organizations
I20260604000212 NC Practitioner - Anesthesiology 9335543750

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Pennsylvania State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians
West Shore Anesthesia Associates, LTDGroup PAC ID 4880506443, 17 clinicians
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8131

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 763-2100

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2026-02696NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Shore Anesthesia Associates, LTD Anesthesiology CurrentSince Nov 1, 2025 Accepting new patients
The Milton S Hershey Medical Center Physcian Group CurrentSince Nov 19, 2025 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Nov 19, 2025 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

500 University Dr
#33
Hershey, PA 17033
Phone (717) 531-1017

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
#41
Hershey, PA 17033
Phone (717) 531-8202

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1003494477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 PARK SOUTH DR STE 510",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071219",
            "telephone_number": "704-304-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "middle_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2026-02696",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD490907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.