Individual provider Active NPI

Thomas Berkley Johnson, DDS

  • Dentist
  • Warrenton, VA
National Provider Identifier
1235214487
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401006380 Issued in VA
Practice address
330 Hospital Dr
Fauquier County Health Dept
Warrenton, VA 20186
Phone
(540) 347-6400
Fax
(540) 347-6405
NPI assigned
Oct 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401006380 VA Primary

Addresses

Primary practice location

330 Hospital Dr
Fauquier County Health Dept
Warrenton, VA 20186

Mailing address

330 Hospital Dr
Fauquier County Health Dept
Warrenton, VA 20186
Phone (540) 347-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131001402 VA Order and Referring Only - DentistPractitioner - Dentist 0749479483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401006380VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Virginia State Board of Health Past Accepting new patients
Commonwealth of Virginia State Board of Health Past Accepting new patients

Organizations & group practices 7

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235214487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR",
            "address_2": "FAUQUIER COUNTY HEALTH DEPT",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "20186",
            "telephone_number": "540-347-6400",
            "fax_number": "540-347-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR",
            "address_2": "FAUQUIER COUNTY HEALTH DEPT",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "20186",
            "telephone_number": "540-347-6400",
            "fax_number": "540-347-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "BERKLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.