Individual provider Active NPI

Austin Dean Johnson, MD

  • Occupational Medicine Physician
  • Owensboro, KY
National Provider Identifier
1003558305
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
61314 Issued in KY
Practice address
2211 Mayfair Dr Ste 102
Owensboro, KY 42301-4569
Phone
(270) 688-1351
Fax
(270) 688-3420
NPI assigned
Apr 8, 2022
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 61314 KY Primary
General Practice Physician 208D00000X A189099 CA

Addresses

Primary practice location

2211 Mayfair Dr Ste 102
Owensboro, KY 42301-4569

Mailing address

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-6491

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-6491

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson132860@direct.owensborohealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825003623 KY Practitioner - Preventive Medicine 4082114806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Loma Linda University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2211 Mayfair Dr
Suite 102
Owensboro, KY 42301-4569
Phone (270) 688-1351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61314KYMDOccupational Medicine Physician
A189099CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc CurrentSince Aug 7, 2025 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Aug 7, 2025 Accepting new patients

Locations

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1003558305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 102",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014569",
            "telephone_number": "270-688-1351",
            "fax_number": "270-688-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-6491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AUSTIN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": "61314",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A189099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson132860@direct.owensborohealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2211 Mayfair Dr Ste 102",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423014569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.