Clifford Q Johnson,Jr, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

7979 Issued in TN

Practice address

9430 Park West Blvd
Ste 330
Knoxville, TN 37923-4203

Phone

(865) 693-6065

Fax

(865) 531-6325

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Tennessee Ear, Nose & Throat Consultants, PC

  • Otolaryngology Physician
  • Knoxville, TN
  • NPI 1255352266
  Medicare reassignment NPD
• Thompson Cancer Survival Center

  • Radiation Oncology Clinic/Center
  • Knoxville, TN
  • NPI 1639113061
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1164424438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31547",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379301547",
            "telephone_number": "865-693-6065",
            "fax_number": "865-531-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 PARK WEST BLVD",
            "address_2": "STE 330",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234203",
            "telephone_number": "865-693-6065",
            "fax_number": "865-531-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON,JR",
        "first_name": "CLIFFORD",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "7979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3166534",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Lynn Johnson II, PHARMD
• Tessa Johnson
• Valresha Johnson, FNP-C
• William L. Johnson, MD
• William R Johnson Jr., MD
• Andrew Blasius Johnston, MD
• Anita O'Fallon Johnston
• Cheri Conley Johnston, M.D.
• Erin Riley Johnston, MD
• Jessica Johnston, RN

• Otolaryngology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Otolaryngology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.