Marshall Johnson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14804 Issued in KY

Practice address

1700 Ring Rd
Elizabethtown, KY 42701-9497

Phone

(270) 769-5551

Fax

(270) 765-3919

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1124027446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019497",
            "telephone_number": "270-769-5551",
            "fax_number": "270-765-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019497",
            "telephone_number": "270-769-5551",
            "fax_number": "270-765-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARSHALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "14804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000045853",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1048777",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64148042",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chasity Lucille Johnson, B.A.
• Debra Lynn Johnson, APRN
• Joyce Lorelle Johnson, APRN
• La Tonya N Johnson
• Maranda Elizabeth Johnson
• Rickibeth Johnson, M.S. CF-SLP
• Samantha Johnson
• Stephanie Johnson, APSS
• Tina Renee Johnson, RN
• Tracy Johnson, APRN

• Surgery Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.