Individual provider Active NPI

Michael Ernest Johnson, M.D.

  • Internal Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1154524742
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008002672 Issued in MO
Practice address
232 S Woods Mill Rd
Hospitalist Program
Chesterfield, MO 63017-3417
Phone
(314) 205-6736
Fax
(314) 576-2319
NPI assigned
Jun 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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 2008002672 MO Primary

Addresses

Primary practice location

232 S Woods Mill Rd
Hospitalist Program
Chesterfield, MO 63017-3417

Mailing address

232 S Woods Mill Rd
Hospitalist Program
Chesterfield, MO 63017-3417
Phone (314) 205-6736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20081027000327 MO Practitioner - Internal Medicine 0042378630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Meharry Medical College School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (800) 501-9855

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Emergency Physicians of St. Luke's, LLC Internal Medicine Past Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC Internal Medicine Past Accepting new patients
Barnes Jewish St Peters Hospital Inc Past Accepting new patients

Locations

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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 4

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": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1154524742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD",
            "address_2": "HOSPITALIST PROGRAM",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173417",
            "telephone_number": "314-205-6736",
            "fax_number": "314-576-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD",
            "address_2": "HOSPITALIST PROGRAM",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173417",
            "telephone_number": "314-205-6736",
            "fax_number": "314-576-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2008002672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.