Individual provider Active NPI

Samantha Jo Johnson, M.D.

  • Obstetrics & Gynecology Physician
  • Pensacola, FL
National Provider Identifier
1154778413
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME138885 Issued in FL
Practice address
2156 W Nine Mile Rd
Pensacola, FL 32534-9464
Phone
(850) 416-2433
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME138885 FL Primary

Addresses

Primary practice location

2156 W Nine Mile Rd
Pensacola, FL 32534-9464

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 1

IdentifierTypeStateIssuer
22641OtherFLFLORIDA STATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201008000629 FL Practitioner - Obstetrics/Gynecology 5890114086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
West Virginia University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

2156 W Nine Mile Rd
Pensacola, FL 32534-9464
Phone (850) 416-2433

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Dec 1, 2021 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Dec 1, 2021 Accepting new patients
Sacred Heart Health System Inc CurrentSince Sep 1, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

2156 W Nine Mile Rd
Pensacola, FL 32534
Phone (850) 416-2433

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Interoperability endpoints

  • Direct secure messaging: samantha.johnson.2@9582.direct.athenahealth.com

Organizations & group practices 6

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 1

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1154778413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349464",
            "telephone_number": "850-416-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME138885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA STATE MEDICAL LICENSE",
            "identifier": "22641",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.