Stan Michael Johnson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39306 Issued in KY

Practice address

238 Cassidy Blvd
Pikeville, KY 41501-1426

Phone

(606) 430-2230

Fax

(606) 437-2526

NPI assigned

Sep 22, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Pediatric Medicine

Education

University of Kentucky College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjohnson37413@pikevillekydirect.org

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.

• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment Care Compare group NPD
• Spero Health of Kentucky, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Danville, KY
  • NPI 1982102109
  Medicare reassignment NPD
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD
• Crider Johnson Pediatrics PSC

  • Pediatrics Physician
  • Pikeville, KY
  • NPI 1114029212
  NPD (past)
• Pikeville Medical Center Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Whitesburg, KY
  • NPI 1871575498
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1184610461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-430-3500",
            "fax_number": "606-437-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 CASSIDY BLVD",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011426",
            "telephone_number": "606-430-2230",
            "fax_number": "606-437-2526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "387 Town Mountain Rd",
            "address_2": "ste 202",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415011640",
            "country_code": "US",
            "telephone_number": "606-437-1008",
            "fax_number": "606-437-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64099344",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson37413@PIKEVILLEKYDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "Direct address for ccda",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Standard Functionality",
            "address_1": "238 Cassidy Blvd",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415011426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• George F. Johnson III, DMD
• Janet Elizabeth Johnson, R.D., L.D., C.L.C.
• Katie Johnson
• Leah Johnson, R.N.
• Megan Leann Johnson, APRN, FNP-C
• Stephanie Johnson
• William M Johnson, MD
• Breanna Jones
• Raven Alexis Jones, APRN
• Trevor Jones, FNP

• Pediatrics Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.