Individual provider Active NPI

Micah Johnson, RVT

  • Vascular Sonography Radiologic Technologist
  • San Antonio, TX
National Provider Identifier
1013530310
Registry record updated Dec 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X
License
135818 Issued in TX
Practice address
718 Lexington Ave
San Antonio, TX 78212-4768
Phone
(210) 251-2024
Fax
(210) 742-9697
NPI assigned
May 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Sonography Radiologic Technologist 2471V0105X 135818 TX Primary

Addresses

Primary practice location

718 Lexington Ave
San Antonio, TX 78212-4768

Mailing address

24165 Ih 10 W Ste 217747
San Antonio, TX 78257-1449
Phone (210) 251-2024

Other practice location 1

9819 Huebner Rd Bldg 4
San Antonio, TX 78240-3253
Phone (254) 718-9172 ext. 001

Other practice location 2

7103 S Peek Rd Ste 300
Richmond, TX 77407-3505
Phone (210) 251-2024

Other practice location 3

641 N New Ballas Rd
Creve Coeur, MO 63141-6713
Phone (210) 251-2024

Other practice location 4

32357 US Highway 281 N
Bulverde, TX 78163-3158
Phone (210) 251-2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
135818TXMDVascular Sonography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Precise Vascular Sonography LLC CurrentSince May 31, 2020 Accepting new patients
Hill Country Wound Care Vascular & Hyperbarics PastSince Mar 1, 2021 Accepting new patients

Locations

641 N New Ballas Rd
Saint Louis, MO 63141
Phone (314) 648-0101

32357 US Highway 281 N
Bulverde, TX 78163
Phone (210) 251-2024

7103 S Peek Rd
Ste 300
Richmond, TX 77407
Phone (210) 251-2024

718 Lexington Ave
San Antonio, TX 78212
Phone (210) 251-2024

9819 Huebner Rd
Bldg 4
San Antonio, TX 78240
Phone (210) 251-2024

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1013530310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 IH 10 W STE 217747",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571449",
            "telephone_number": "210-251-2024",
            "fax_number": "210-742-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 LEXINGTON AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124768",
            "telephone_number": "210-251-2024",
            "fax_number": "210-742-9697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9819 Huebner Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782403253",
            "country_code": "US",
            "telephone_number": "254-718-9172 x001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7103 S Peek Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774073505",
            "country_code": "US",
            "telephone_number": "210-251-2024",
            "fax_number": "210-742-9697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "641 N New Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631416713",
            "country_code": "US",
            "telephone_number": "210-251-2024",
            "fax_number": "210-742-9697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32357 US Highway 281 N",
            "address_purpose": "LOCATION",
            "city": "Bulverde",
            "state": "TX",
            "postal_code": "781633158",
            "country_code": "US",
            "telephone_number": "210-251-2024",
            "fax_number": "210-742-9697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICAH",
        "name_prefix": "Mr.",
        "credential": "RVT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "TX",
            "license": "135818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.