Beverly Ann Johnson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME134621 Issued in FL

Practice address

2000 Meade Pkwy
Suffolk, VA 23434-4260

Phone

(757) 934-9395

NPI assigned

Sep 7, 2006

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, VA, WA3 enrollments

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 3

Specialty

Dermatology

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prosser Memorial Hospital Hospital, Prosser, WA, CCN 501312

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bjohnson@dat1977.srs-direct.com

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.

• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387
  Medicare reassignment NPD
• Kindred Hair & Skin Center, LLC

  • Dermatology Physician
  • Marriottsville, MD
  • NPI 1992220826
  Medicare reassignment
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Medicare reassignment
• Bayview Physician Services, PC

  dba LMC Radiology

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Prosser Public Hospital District of Benton County

  dba Benton City Clinic

  • Rural Health Clinic/Center
  • Benton City, WA
  • NPI 1437199072
  NPD
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health Spine Clinic

  • Specialist
  • Walla Walla, WA
  • NPI 1518770155
  NPD
• Bayview Medical Center, Inc

  dba LMC Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Suffolk, VA
  • NPI 1568466209
  NPD (past)
• Prosser Public Hospital District of Benton County

  dba Grandview Clinic

  • Rural Health Clinic/Center
  • Grandview, WA
  • NPI 1376026237
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1255434742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100279",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100279",
            "telephone_number": "352-594-1942",
            "fax_number": "352-594-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344260",
            "telephone_number": "757-934-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101283661",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME134621",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "13244",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME134621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portugal Johnson Banks
• Aaron Donald Johnson
• Abbey Elaine Johnson
• Alexis Johnson, NCC,LPC
• Andrea Johnson
• Cornelius Johnson Jr., BS, RBT, QMHP-T
• Dahlia Johnson
• Krystal Geneva Johnson, M.ED., ATC
• Lisa Rose Johnson, ED.D.
• Marcus Tyrone Johnson

• Dermatology Physician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.