Active NPI
Amy E Johnson, M.D.
- Pediatrics Physician
- Jackson, TN
National Provider Identifier
1073578456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD63332
- Practice address
- 2863 Highway 45 Byp
Jackson, TN 38305-3618 - Phone
- (731) 422-0213
- Fax
- (731) 660-8369
- NPI assigned
- Apr 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 49323 | CO | |
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | DR.0049323 | CO | |
| Pediatrics Physician | 208000000X | INPROCESS | TN | |
| Pediatrics Physician | 208000000X | MD63332 | TN | Primary |
Addresses
Primary practice location
2863 Highway 45 Byp
Jackson, TN 38305-3618
Mailing address
PO Box 400
Jackson, TN 38302-0400
Phone (731) 422-0213
Other names 1
- Amy Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0049323 | CO | MD | Pediatric Emergency Medicine (Emergency Medicine) Physician |
| MD63332 | TN | MD | Pediatrics Physician |
| INPROCESS | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Pediatrics | Current | Accepting new patients |
| Ut Lebonheur Pediatric Specialists, Inc. | Pediatrics | Current | Accepting new patients |
| Paragon Emergency Physicians PC | Past | Accepting new patients | |
| After Hours Pediatrics PC | Pediatrics | Past | Accepting new patients |
Locations
100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594
Interoperability endpoints
- ajohnson43645@mlh.direct-ci.com
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Memphis, TN
- NPI 1306335088
-
- Pediatrics Physician
- Memphis, TN
- NPI 1093024101
-
- Pediatrics Physician
- Albuquerque, NM
- NPI 1588730360
-
- Emergency Medicine Physician
- Snellville, GA
- NPI 1396782967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1073578456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 400",
"city": "JACKSON",
"state": "TN",
"postal_code": "383020400",
"telephone_number": "731-422-0213",
"fax_number": "731-422-5743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2863 HIGHWAY 45 BYP",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053618",
"telephone_number": "731-422-0213",
"fax_number": "731-660-8369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMY",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-19",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "49323",
"primary": false
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "CO",
"license": "DR.0049323",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "INPROCESS",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD63332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "JOHNSON",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.