Teddy R Johnson, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0103000769 Issued in VA

Practice address

680 W Monroe St
Wytheville, VA 24382-2240

Phone

(276) 228-2212

Fax

(276) 228-7835

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15108/brand/1/csg/1/fhir/r4
• Direct secure messaging: drjohnson@southwestpodiatry.ssdirect.aprima.com

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.

• Soutwest Podiatry, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Wytheville, VA
  • NPI 1942256490
  Medicare reassignment NPD

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1073576062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 W MONROE ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822240",
            "telephone_number": "276-228-2212",
            "fax_number": "276-228-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 W MONROE ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822240",
            "telephone_number": "276-228-2212",
            "fax_number": "276-228-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TEDDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103000769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "101911",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5442037",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "324212",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "101908",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9020630",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "324208",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Jarvis, BCABA
• Gordon W Jennings, OD PC
• Jerry R Willis DC (Willis Chiropractic)
• Tonya Renee Johnson-Clark, COTA
• Molly L Johnson, FNP-BC
• Darren B Jones, B.S.
• Matthew A Jones, NP-C
• Feliciano J Jusay, M.D.
• Linda Kay Justice
• Ashleigh D. Justus, LICENSED PHYSICAL TH

• Foot & Ankle Surgery Podiatrist in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Foot & Ankle Surgery Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.