Individual provider Active NPI

John S Johnson, M.D.

  • Internal Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1083602882
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C8443 Issued in AR
Practice address
225 E Washington Ave
Jonesboro, AR 72401-3111
Phone
(870) 207-1539
Fax
(870) 207-6581
NPI assigned
Oct 6, 2005
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C8443 AR Primary

Addresses

Primary practice location

225 E Washington Ave
Jonesboro, AR 72401-3111

Mailing address

107 Huntcliff Dr
Jonesboro, AR 72404-8844
Phone (870) 761-2182

Other identifiers 1

IdentifierTypeStateIssuer
129915001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000646 AR Practitioner - Internal Medicine 1153215520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Rehab Group LLPGroup PAC ID 9133429152, 3 clinicians

Practice addresses (Care Compare)

1201 Fleming Ave
Jonesboro, AR 72401-4311
Phone (870) 933-5174

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc CurrentSince Jan 1, 2007 Accepting new patients
St Bernards Hospital Inc. CurrentSince Jan 1, 2007 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Medical Rehab Group LLP CurrentSince Dec 1, 2016 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

111 S Main St
Leachville, AR 72438
Phone (870) 539-1115

Interoperability endpoints

  • Direct secure messaging: johnjohnson@sbpc.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1083602882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HUNTCLIFF DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048844",
            "telephone_number": "870-761-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013111",
            "telephone_number": "870-207-1539",
            "fax_number": "870-207-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C8443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129915001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.