Derrick Lynn Johnston, M.D.

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

51576 Issued in AZ

Practice address

5166 E Glenn St
Tucson, AZ 85712-1337

Phone

(520) 795-5338

Fax

(520) 795-5382

NPI assigned

Jun 23, 2009

Last updated

Jun 2, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Clinics for Rehabilitative Services

  dba Children's Clinics

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1063454346
  Medicare reassignment NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• Rincon ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Tucson, AZ
  • NPI 1275206880
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1184852709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5166 E GLENN ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121337",
            "telephone_number": "520-795-5338",
            "fax_number": "520-795-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5166 E GLENN ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121337",
            "telephone_number": "520-795-5338",
            "fax_number": "520-795-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "DERRICK",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "AZ",
            "license": "51576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William P Johnson, MD
• Yvonne Irene Johnson, PHARMD
• Zachary Jay Johnson
• Amelia Johnston, RN
• Cynthia Cochran Johnston, M.D.
• Jennifer Johnston, MD
• Karen Cecile Johnston, MD
• Lauren Kaye Johnston, DPT, PT
• Lindsey Johnston, PT, DPT
• Lucas A Johnston, DPT, PT

• Pediatric Urology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pediatric Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.