Active NPI
Jeanette R Johnson, DPM
- Primary Podiatric Medicine Podiatrist
- Pinehurst, NC
National Provider Identifier
1255337804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- 531
- Practice address
- 6 Regional CR
Suite a
Pinehurst, NC 28374 - Phone
- (910) 295-9255
- Fax
- (910) 295-7255
- NPI assigned
- Jun 27, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 531 | NC | Primary |
Addresses
Primary practice location
6 Regional CR
Suite a
Pinehurst, NC 28374
Mailing address
6 Regional CR
Suite a
Pinehurst, NC 28374
Phone (910) 295-9255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65554 | Other | FL | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 531 | NC | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwin H Hamilton PA | Past | Accepting new patients | |
| JRJ Podiatry Inc | Primary Podiatric Medicine | Past | Accepting new patients |
| Pinehurst Foot Specialist | Primary Podiatric Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Podiatric Clinic/Center
- Pinehurst, NC
- NPI 1578692703
Primary Podiatric Medicine
-
- Family Medicine Physician
- Ft Lauderdale, FL
- NPI 1700205770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1255337804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 REGIONAL CR",
"address_2": "SUITE A",
"city": "PINEHURST",
"state": "NC",
"postal_code": "28374",
"telephone_number": "910-295-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 REGIONAL CR",
"address_2": "SUITE A",
"city": "PINEHURST",
"state": "NC",
"postal_code": "28374",
"telephone_number": "910-295-9255",
"fax_number": "910-295-7255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JEANETTE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-27",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NC",
"license": "531",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "65554",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.