Individual provider Active NPI

David P Johnson, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1235180084
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39070 Issued in WI
Practice address
1121 E North Ave
Columbia-St. Mary'S Family Practice
Milwaukee, WI 53212-3515
Phone
(414) 267-6500
Fax
(414) 267-3894
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39070 WI Primary

Addresses

Primary practice location

1121 E North Ave
Columbia-St. Mary'S Family Practice
Milwaukee, WI 53212-3515

Mailing address

1121 E North Ave
Columbia-St. Mary'S Family Practice
Milwaukee, WI 53212-3515
Phone (414) 267-6500

Other identifiers 2

IdentifierTypeStateIssuer
1235180084MedicaidWI
004000215WOtherHUMANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080429000618 WI Practitioner - Family Practice 5799864989 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

220 W Capitol Dr
Milwaukee, WI 53212-1185
Phone (414) 727-6320

7208 N 76TH St
Milwaukee, WI 53223-4502
Phone (414) 454-4800

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39070WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Health Services, Inc. Current Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Jul 26, 1999 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Jan 30, 2024 Accepting new patients
Outreach Community Health Centers, Inc. CurrentSince Jan 30, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Nov 15, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Nov 15, 2024 Accepting new patients
Milwaukee Health Services Inc CurrentSince Jul 1, 2023 Accepting new patients
Milwaukee Health Services, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

2555 N Mlk Dr
Milwaukee, WI 53212
Phone (414) 267-2022

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8200 W Silver Spring Dr
Milwaukee, WI 53218
Phone (414) 760-3900

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1235180084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "address_2": "COLUMBIA-ST. MARY'S FAMILY PRACTICE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6500",
            "fax_number": "414-267-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "address_2": "COLUMBIA-ST. MARY'S FAMILY PRACTICE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6500",
            "fax_number": "414-267-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235180084",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "004000215W",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.