Charles Marvin Johnson, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001211 Issued in MI

Practice address

10244 W 7 Mile Rd
Detroit, MI 48221-1904

Phone

(313) 862-5800

Fax

(313) 862-2865

NPI assigned

Oct 6, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Charles M Johnson Podiatrist PC

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
  • NPI 1902955560
  Medicare reassignment NPD Authorized official
• Charles Johnson DPM

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
  • NPI 1760531628
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1245327543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10244 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211904",
            "telephone_number": "313-862-5800",
            "fax_number": "313-862-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10244 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211904",
            "telephone_number": "313-862-5800",
            "fax_number": "313-862-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "middle_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "CJ001211",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "480H232610",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4866541",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "4858250260",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Challaduh Johnson
• Chanique Tachelle Johnson
• Channell Loraine Johnson, LLMSW
• Chantell Renee Johnson
• Charise Johnson
• Charnita Johnson, LLMSW
• Chelsea Miguel Johnson, MD
• Christallin Johnson
• Christin Johnson
• Christina Johnson

• Podiatrist in Detroit, MI
• Providers in Detroit, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.