Individual provider Active NPI

Donald F. Johnson, M.D.

  • Pediatrics Physician
  • Silver City, NM
National Provider Identifier
1093713109
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
96-80 Issued in NM
Practice address
114 W 11TH St
HMS Med Square
Silver City, NM 88061-5136
Phone
(575) 388-1511
Fax
(575) 388-3465
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 96-80 NM Primary

Addresses

Primary practice location

114 W 11TH St
HMS Med Square
Silver City, NM 88061-5136

Mailing address

114 W. 11TH Street
HMS Med Square
Silver City, NM 88061
Phone (575) 388-1511

Other identifiers 1

IdentifierTypeStateIssuer
J2516MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20050830000973 NM Practitioner - Pediatric Medicine 2961438239 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96-80NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hidalgo Medical Services Current Accepting new patients
Hidalgo Medical Services CurrentSince Jul 1, 2005 Accepting new patients
Hidalgo Medical Services CurrentSince Jul 1, 2005 Accepting new patients

Locations

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2368

114 W 11th St
Silver City, NM 88061
Phone (575) 388-1511

Organizations & group practices 3

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1093713109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W. 11TH STREET",
            "address_2": "HMS MED SQUARE",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "88061",
            "telephone_number": "575-388-1511",
            "fax_number": "575-388-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W 11TH ST",
            "address_2": "HMS MED SQUARE",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615136",
            "telephone_number": "575-388-1511",
            "fax_number": "575-388-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DONALD",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "96-80",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J2516",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.