Individual provider Active NPI

Ankrehah Trimble Johnson, DO

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1205068525
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO 1167 Issued in AL
Practice address
48 Medical Park Dr E
Suite 154
Birmingham, AL 35235-3400
Phone
(205) 202-5650
Fax
(205) 202-5655
NPI assigned
Aug 20, 2009
Last updated
Jun 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO 1167 AL Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X DO 1167 AL
Adult Medicine Physician 207QA0505X DO 1167 AL
Geriatric Medicine (Family Medicine) Physician 207QG0300X DO 1167 AL

Addresses

Primary practice location

48 Medical Park Dr E
Suite 154
Birmingham, AL 35235-3400

Mailing address

48 Medical Park Dr E
Suite 154
Birmingham, AL 35235-3400
Phone (205) 202-5650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110325000786 AL Practitioner - Family Practice 9537342670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4643 Camp Coleman Rd
Suite 117
Trussville, AL 35173-2838
Phone (205) 202-5650

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO 1167ALMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brownstone Total Family Healthcare, PC Family Medicine CurrentSince Apr 10, 2012 Accepting new patients
Oral & Facial Surgery of Al, PC Past Accepting new patients
American Family Care, LLC Family Medicine Past Accepting new patients

Locations

1700 5th Ave N
Birmingham, AL 35203
Phone (205) 251-0404

48 Medical Park Dr E
Ste 154
Birmingham, AL 35235
Phone (205) 578-2383

4643 Camp Coleman Rd
Ste 117
Trussville, AL 35173
Phone (205) 202-5650

Interoperability endpoints

  • Direct secure messaging: ankrehah.johnson@lwc-al.direct.office.nextgen.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGHIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGHIBA/Endpoint/AGHIBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1205068525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 154",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-202-5650",
            "fax_number": "205-202-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 154",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-202-5650",
            "fax_number": "205-202-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANKREHAH",
        "middle_name": "TRIMBLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO 1167",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "AL",
            "license": "DO 1167",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AL",
            "license": "DO 1167",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "DO 1167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.