Individual provider Active NPI

Bryan G. Johnson, MD

  • Internal Medicine Physician
  • Frisco, TX
National Provider Identifier
1154340925
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L0833 Issued in TX
Practice address
6842 W Main St
Suite 203
Frisco, TX 75033-4243
Phone
(469) 633-9300
Fax
(469) 633-9301
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L0833 TX Primary

Addresses

Primary practice location

6842 W Main St
Suite 203
Frisco, TX 75033-4243

Mailing address

6842 W Main St
Suite 203
Frisco, TX 75033-4243
Phone (469) 633-9300

Other identifiers 1

IdentifierTypeStateIssuer
29664201MedicaidTX

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
I20051214000823 TX Practitioner - Internal Medicine 1759302060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

5701 Virginia Pkwy
McKinney, TX 75071-5652
Phone (214) 592-0212

6842 Main St
Suite 203
Frisco, TX 75033-4243

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan G. Johnson MD, PA Internal Medicine CurrentSince May 7, 2008 Accepting new patients

Locations

6842 Main St
Ste 203
Frisco, TX 75033
Phone (469) 633-9300

Interoperability endpoints

  • Direct secure messaging: menstclinic.bryanjohnson@126413.advancedmd-direct.com
  • Direct secure messaging: dmcbrjohn@yourcarecommunity.org

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 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1154340925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6842 W MAIN ST",
            "address_2": "SUITE 203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334243",
            "telephone_number": "469-633-9300",
            "fax_number": "469-633-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6842 W MAIN ST",
            "address_2": "SUITE 203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334243",
            "telephone_number": "469-633-9300",
            "fax_number": "469-633-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29664201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.