Individual provider Active NPI

Premila Lakshmi Singh Johnson, MD

  • Internal Medicine Physician
  • Midland, TX
National Provider Identifier
1184727562
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M3739 Issued in TX
Practice address
2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808
Phone
(432) 683-9898
Fax
(432) 695-6102
NPI assigned
Sep 7, 2006
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M3739 TX Primary
Pediatrics Physician 208000000X M3739 TX

Addresses

Primary practice location

2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808

Mailing address

2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808
Phone (432) 683-9898

Other identifiers 1

IdentifierTypeStateIssuer
094778003MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070605000250 TX Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4880792449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Baylor College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2300 W Michigan Ave
Suite 5
Midland, TX 79701-5855
Phone (432) 683-9898

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M3739TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premila Johnson, MD LP Internal Medicine CurrentSince Jun 11, 2012 Accepting new patients
Premier Family Care I, Inc Internal Medicine PastSince Nov 1, 2014 Accepting new patients
Midland Family Physicians, P. a. Past Accepting new patients

Locations

2300 W Michigan Ave
Ste 5
Midland, TX 79701
Phone (432) 413-5496

Interoperability endpoints

  • Direct secure messaging: premila.johnson.1@28496.direct.athenahealth.com

Organizations & group practices 3

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1184727562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W MICHIGAN AVE",
            "address_2": "SUITE 5",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015808",
            "telephone_number": "432-683-9898",
            "fax_number": "432-695-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W MICHIGAN AVE",
            "address_2": "SUITE 5",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015808",
            "telephone_number": "432-683-9898",
            "fax_number": "432-695-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PREMILA",
        "middle_name": "LAKSHMI SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3739",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M3739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094778003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.