Individual provider Active NPI

David Kinnaird Johnson, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Greenville, OH
National Provider Identifier
1063414712
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35-04-7132-J Issued in OH
Practice address
1111 Sweitzer St
Greenville, OH 45331-1189
Phone
(937) 547-5714
Fax
(937) 547-5792
NPI assigned
Aug 12, 2005
Last updated
Aug 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 35-04-7132-J OH Primary

Addresses

Primary practice location

1111 Sweitzer St
Greenville, OH 45331-1189

Mailing address

835 Sweitzer St
Greenville, OH 45331-1077
Phone (937) 569-5704

Other identifiers 1

IdentifierTypeStateIssuer
0576336MedicaidOH

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1063414712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SWEITZER ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311077",
            "telephone_number": "937-569-5704",
            "fax_number": "937-547-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SWEITZER ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311189",
            "telephone_number": "937-547-5714",
            "fax_number": "937-547-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "KINNAIRD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35-04-7132-J",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0576336",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.