Individual provider Active NPI

Amy S. Johnson, M.D.

  • Family Medicine Physician
  • Pocomoke, MD
National Provider Identifier
1245292853
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0058928 Issued in MD
Practice address
305 10TH St
Suite 101
Pocomoke, MD 21851-1607
Phone
(410) 957-3005
Fax
(410) 957-0550
NPI assigned
Apr 6, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 D0058928 MD Primary

Addresses

Primary practice location

305 10TH St
Suite 101
Pocomoke, MD 21851-1607

Mailing address

305 10TH St
Suite 101
Pocomoke, MD 21851-1607
Phone (410) 957-3005

Other identifiers 5

IdentifierTypeStateIssuer
245973OtherVAPROVIDER NO.
61721001OtherMDPROVIDER NO.
F094 0007OtherMDPROVIDER NO.
181482OtherMDPROVIDER NO.
877172OtherMDPROVIDER NO.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100514000323 MD Practitioner - Family Practice 7315075140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

305 10TH St
Pocomoke City, MD 21851-1607
Phone (410) 957-3011

400 Eastern Shore Dr
Salisbury, MD 21804-5513
Phone (410) 543-8240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions41
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0058928MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

305 10th St
Ste 101
Pocomoke City, MD 21851
Phone (410) 912-6167

400 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 543-2255

Organizations & group practices 2

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 1

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245292853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 10TH ST",
            "address_2": "SUITE 101",
            "city": "POCOMOKE",
            "state": "MD",
            "postal_code": "218511607",
            "telephone_number": "410-957-3005",
            "fax_number": "410-957-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 10TH ST",
            "address_2": "SUITE 101",
            "city": "POCOMOKE",
            "state": "MD",
            "postal_code": "218511607",
            "telephone_number": "410-957-3005",
            "fax_number": "410-957-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0058928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "245973",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "61721001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "F094 0007",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "181482",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "877172",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocomoke, MD

Sources for this page

Verify at the official NPI Registry.