Individual provider Active NPI

Wallace R Johnson, M.D.

  • Hypertension Specialist Physician
  • Columbia, MD
National Provider Identifier
1043253867
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hypertension Specialist PhysicianTaxonomy code 207RH0005X
License
D38086 Issued in MD
Practice address
9175 Guilford Rd Ste 140
Columbia, MD 21046-1849
Phone
(410) 512-9202
Fax
(949) 991-1377
NPI assigned
Jun 13, 2006
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hypertension Specialist Physician 207RH0005X D38086 MD Primary

Addresses

Primary practice location

9175 Guilford Rd Ste 140
Columbia, MD 21046-1849

Mailing address

9175 Guilford Rd Ste 300
Columbia, MD 21046-2565
Phone (410) 512-9122

Other practice location 1

9175 Guilford Rd Ste 300
Columbia, MD 21046-2565
Phone (410) 512-9122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040706000797 MD Practitioner - Internal Medicine 1557348729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians PA Internal Medicine Current Accepting new patients
University of Maryland Physicians P.a. CurrentSince Jul 1, 1996 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University Care LLC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University Care Past Accepting new patients
Call Doctor Packer Telemedicine, LLC Internal Medicine PastSince Apr 22, 2026 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Ste 600
Baltimore, MD 21201
Phone (410) 328-5793

118 Westminster Pike
Ste 106
Reisterstown, MD 21136
Phone (410) 876-0086

Interoperability endpoints

  • Direct secure messaging: wjohnson6210@direct.umm.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1043253867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9175 GUILFORD RD STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462565",
            "telephone_number": "410-512-9122",
            "fax_number": "949-991-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9175 GUILFORD RD STE 140",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461849",
            "telephone_number": "410-512-9202",
            "fax_number": "949-991-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9175 Guilford Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210462565",
            "country_code": "US",
            "telephone_number": "410-512-9122",
            "fax_number": "949-991-1359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WALLACE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "MD",
            "license": "D38086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.