Organization Active NPI

Bryan G. Johnson MD, PA

  • Internal Medicine Physician
  • Frisco, TX
National Provider Identifier
1043491327
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L0833 Issued in TX
Legal business name
BRYAN G. JOHNSON MD, PA
Practice address
6842 W Main St
203
Frisco, TX 75033-4243
Phone
(469) 633-9300
Fax
(469) 633-9301
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Dr. Bryan G Johnson, MDNPI 1154340925
Title
Physician/Owner
Phone
(469) 633-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X L0833 TX Primary

Addresses

Primary practice location

6842 W Main St
203
Frisco, TX 75033-4243

Mailing address

6842 W Main St
203
Frisco, TX 75033-4243
Phone (469) 633-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080620000615 TX Part B Supplier - Clinic/Group Practice 0547330417 Receives reassigned benefits from 1 practitioner
Practice locations: Frisco, TX

National Provider Directory

National Provider Directory

Locations

6842 Main St
Ste 203
Frisco, TX 75033
Phone (469) 633-9300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1043491327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6842 W MAIN ST",
            "address_2": "203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334243",
            "telephone_number": "469-633-9300",
            "fax_number": "469-633-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6842 W MAIN ST",
            "address_2": "203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334243",
            "telephone_number": "469-633-9300",
            "fax_number": "469-633-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN G. JOHNSON MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "469-633-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.