Active NPI
Caroline Johnson, MD
- Nephrology Physician
- Temple, TX
National Provider Identifier
1124249552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- R4403
- Practice address
- 2601 Thornton LN
Temple, TX 76502-1808 - Phone
- (254) 724-6622
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 42099 | AZ | |
| Nephrology Physician | 207RN0300X | 42099 | AZ | |
| Pediatrics Physician | 208000000X | 42099 | AZ | |
| Nephrology Physician | 207RN0300X | R4403 | TX | Primary |
Addresses
Primary practice location
2601 Thornton LN
Temple, TX 76502-1808
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other practice location 1
13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42099 | AZ | MD | Internal Medicine Physician |
| R4403 | TX | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scottsdale Primary Care, PC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1184971376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1124249552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 THORNTON LN",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021808",
"telephone_number": "254-724-6622"
}
],
"practiceLocations": [
{
"address_1": "13400 E Shea Blvd",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "852595452",
"country_code": "US",
"telephone_number": "480-301-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "CAROLINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "42099",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "AZ",
"license": "42099",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "42099",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "R4403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.