Individual provider Active NPI

Gerald Jerard Johnson, M.D.

  • Internal Medicine Physician
  • McKinney, TX
National Provider Identifier
1093739716
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M3276 Issued in TX
Practice address
5252 W University Dr
Attn: Mkipcu
McKinney, TX 75071-7822
Phone
(469) 764-6950
Fax
(469) 764-6954
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X M3276 TX
Internal Medicine Physician 207R00000X M3276 TX Primary

Addresses

Primary practice location

5252 W University Dr
Attn: Mkipcu
McKinney, TX 75071-7822

Mailing address

5252 W University Dr
Attn: Mkipcu
McKinney, TX 75071-7822
Phone (469) 764-6950

Other identifiers 3

IdentifierTypeStateIssuer
1805921-04MedicaidTX
180592101MedicaidTX
200098530AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjohnson457118@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060801000397 TX Practitioner - Internal MedicinePractitioner - Hospitalist 8325051782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

5252 W University Dr
McKinney, TX 75071-7822
Phone (469) 764-6950

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Centennial Hospital, Frisco, TX, CCN 450885
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M3276TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Baylor Scott & White Medical Center - Centennial Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 2

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.

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1093739716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 W UNIVERSITY DR",
            "address_2": "ATTN: MKIPCU",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717822",
            "telephone_number": "469-764-6950",
            "fax_number": "469-764-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 W UNIVERSITY DR",
            "address_2": "ATTN: MKIPCU",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717822",
            "telephone_number": "469-764-6950",
            "fax_number": "469-764-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GERALD",
        "middle_name": "JERARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M3276",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1805921-04",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180592101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098530A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjohnson457118@direct.sw.org",
            "affiliation": "N",
            "address_1": "12505 Lebanon Rd Ste 1442",
            "city": "Frisco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750358298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.