Individual provider Active NPI

Gregory Michael Johnston, M.D.

  • General Practice Physician
  • Tacoma, WA
National Provider Identifier
1043282023
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101235436 Issued in VA
Practice address
Madigan Army Medical Center
Department of Emergency Medicine
Tacoma, WA 98431-0001
Phone
(253) 968-1390
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101235436 VA Primary

Addresses

Primary practice location

Madigan Army Medical Center
Department of Emergency Medicine
Tacoma, WA 98431-0001

Mailing address

1412 Kittson St
Dupont, WA 98327-9719
Phone (253) 964-2158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20151229000680 VA Practitioner - Emergency Medicine 5092886887 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101235436VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsburg Emergency Physicians CurrentSince Jan 1, 2016 Accepting new patients
Williamsburg Emergency Physicians CurrentSince Jan 1, 2016 Accepting new patients
Conemaugh Valley Memorial Hospital Past Accepting new patients

Locations

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1043282023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 KITTSON ST",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279719",
            "telephone_number": "253-964-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101235436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.