NPIMap

Individual provider Active NPI

Matthew A Johnson, MD

  • Family Medicine Physician
  • Lynchburg, VA
National Provider Identifier
1073595799
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101057967 Issued in VA
Practice address
2323 Memorial Ave
Suite 10
Lynchburg, VA 24501-2661
Phone
(434) 200-5200
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101057967 VA Primary

Addresses

Primary practice location

2323 Memorial Ave
Suite 10
Lynchburg, VA 24501-2661

Mailing address

1204 Fenwick Dr
Lynchburg, VA 24502-2112

Other identifiers 3

IdentifierTypeStateIssuer
005614023MedicaidVA
119865OtherANTHEM
080154922OtherMEDICARE RAILROAD PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000983 SC Practitioner - Family Practice 0446225387 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Aug 6, 2022 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Family Medicine CurrentSince Oct 15, 2022 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Aug 6, 2022 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Oct 15, 2022 Accepting new patients
McLeod Health Clarendon Family Medicine CurrentSince May 10, 2022 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Aug 6, 2022 Accepting new patients
Swiftcare of MD, PC CurrentSince Dec 15, 2021 Accepting new patients
McLeod Health Cheraw Family Medicine CurrentSince Aug 6, 2022 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Aug 4, 2022 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Aug 4, 2022 Accepting new patients
McLeod Health Clarendon CurrentSince May 10, 2022 Accepting new patients
Central Virginia Family Physicians, Inc. Laboratory PastSince Jan 1, 2003 Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

Interoperability endpoints

  • Direct secure messaging: matthewjohnson@coan.allscriptsdirect.net
  • Direct secure messaging: mjohnson24135@directmcleodehealth.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1073595799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 FENWICK DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 MEMORIAL AVE",
            "address_2": "SUITE 10",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012661",
            "telephone_number": "434-200-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101057967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005614023",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "119865",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "080154922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.