David R Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01037139 Issued in IN

Practice address

2001 W 86TH St.
St. Vincent Emergency Physicians, Inc
Indpls, IN 46260-1902

Phone

(317) 802-3140

Fax

(317) 870-0499

NPI assigned

Nov 22, 2005

Last updated

Jan 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1043293244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 RELIABLE PKWY",
            "address_2": "ST VINCENT EMERGENCY PHYSICIANS, INC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860046",
            "telephone_number": "317-802-3140",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST.",
            "address_2": "ST. VINCENT EMERGENCY PHYSICIANS, INC",
            "city": "INDPLS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-802-3140",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01037139",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037139A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200013750",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200013730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cletis R Foster, DDS
• Tejuana Garnes, LICENSED CLINICAL SO
• Abbie Ann Grudzien
• Deidre East Guerrettaz, DDS
• Healthy Feet LLC
• Sarah Lynn Jones
• Elizabeth Anne Judd, PT
• Joann Lichtenberg, LCSW
• Bulva Lucas, LCSW
• Dianne Martin, MD

• Family Medicine Physician in Indpls, IN
• Providers in Indpls, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.