Individual provider Active NPI

William Arnold Johnson Sr., MD

  • Ophthalmology Physician
  • Columbia, SC
National Provider Identifier
1093778490
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6727 Issued in SC
Practice address
1920 Pickens St
Columbia, SC 29201
Phone
(803) 779-3070
Fax
(803) 771-7639
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 6727 SC Primary

Addresses

Primary practice location

1920 Pickens St
Columbia, SC 29201

Mailing address

PO Box 60371
Charlotte, NC 28260-0371
Phone (803) 779-3070

Other identifiers 1

IdentifierTypeStateIssuer
067279MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6727SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Surg Center Inc Past Accepting new patients
Columbia Eye Clinic PA Ophthalmology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1093778490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60371",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600371",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "ARNOLD",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "6727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067279",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.