Individual provider Active NPI

David P. Johnson, M.D.

  • Pain Medicine Physician
  • Destin, FL
National Provider Identifier
1134530926
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME139293 Issued in FL
Practice address
36474C Emerald Coast Pkwy Ste 3101
Destin, FL 32541-6701
Phone
(850) 863-2153
NPI assigned
May 14, 2014
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MD38074 AL
Pain Medicine (Anesthesiology) Physician 207LP2900X ME139293 FL
Pain Medicine (Anesthesiology) Physician 207LP2900X 085105 GA
Interventional Pain Medicine Physician 208VP0014X ME139293 FL
Pain Medicine Physician 208VP0000X ME139293 FL Primary

Addresses

Primary practice location

36474C Emerald Coast Pkwy Ste 3101
Destin, FL 32541-6701

Mailing address

36474C Emerald Coast Pkwy Ste 3101
Destin, FL 32541-6701
Phone (850) 863-2153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, AL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190710001765 FL Practitioner - Pain Management 9638396963 Reassigns benefits to 2 organizations
I20200324001763 GA Practitioner - Anesthesiology 9638396963 Reassigns benefits to 1 organization
I20231221001621 AL Practitioner - Anesthesiology 9638396963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone (850) 344-1646

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38074ALMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC Current Accepting new patients
USA Health Anesthesia Billing Services, LLC CurrentSince Nov 1, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Sep 1, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince Sep 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Interventional Pain Medicine Past Accepting new patients

Locations

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

5300 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 344-1646

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

Interoperability endpoints

  • Direct secure messaging: david.johnson.1@9109.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1134530926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36474C EMERALD COAST PKWY STE 3101",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325416701",
            "telephone_number": "850-863-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36474C EMERALD COAST PKWY STE 3101",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325416701",
            "telephone_number": "850-863-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": "MD38074",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME139293",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "085105",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME139293",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME139293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.