Individual provider Active NPI

Yvette C. Johnson-Threat, M.D.

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1164454740
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101054237 Issued in VA
Practice address
1510 N 28TH St
Suite 308
Richmond, VA 23223-5311
Phone
(804) 644-1665
Fax
(804) 644-5285
NPI assigned
Jul 6, 2006
Last updated
Nov 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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 0101054237 VA Primary

Addresses

Primary practice location

1510 N 28TH St
Suite 308
Richmond, VA 23223-5311

Mailing address

1510 N 28TH St
Suite 308
Richmond, VA 23223-5311
Phone (804) 644-1665

Other identifiers 9

IdentifierTypeStateIssuer
2104493OtherVAMAMSI
5487309OtherVAAETNA LIFE
P00153281OtherVARAILROAD MEDICARE
6246708OtherVACIGNA
463643OtherVAANTHEM BCBS OF VA
65960OtherVASENTARA
010023921MedicaidVA
5487309OtherVAAETNA HMO
212408OtherVASOUTHERN HEALTH SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101054237VAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1164454740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N 28TH ST",
            "address_2": "SUITE 308",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235311",
            "telephone_number": "804-644-1665",
            "fax_number": "804-644-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N 28TH ST",
            "address_2": "SUITE 308",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235311",
            "telephone_number": "804-644-1665",
            "fax_number": "804-644-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-THREAT",
        "first_name": "YVETTE",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101054237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2104493",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA LIFE",
            "identifier": "5487309",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00153281",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6246708",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF VA",
            "identifier": "463643",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "65960",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010023921",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "5487309",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH SERVICES",
            "identifier": "212408",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.