Active NPI
Jay Thomas Johnson, DO
- Emergency Medicine Physician
- Georgetown, SC
National Provider Identifier
1265626006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 36493
- Practice address
- 606 Black River Rd
Georgetown, SC 29440-3368 - Phone
- (843) 527-7000
- Fax
- (843) 520-8403
- NPI assigned
- Sep 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | N6894 | TX | |
| Emergency Medicine Physician | 207P00000X | 36493 | SC | Primary |
Addresses
Primary practice location
606 Black River Rd
Georgetown, SC 29440-3368
Mailing address
PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 527-7000
Other practice location 1
642 S 2nd St
Apt 1003
Louisville, KY 40202-2433
Phone (623) 910-8797
Other practice location 2
4070 Highway 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218445901 | Medicaid | TX | |
| 218445902 | Medicaid | TX | |
| P00896831 | Other | TX | RAILROAD |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jjohnson447813@direct.musc.edu | Direct | Waccamaw Community Hospital |
| Direct Messaging Address | jjohnson447813@direct.musc.edu | Georgetown Memorial Hospital |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140428000349 | SC | Practitioner - Emergency Medicine | 8325108822 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Georgetown Memorial Hospital
Practice addresses (Care Compare)
606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7000
Hospital & facility affiliations
- Tidelands Waccamaw Community Hospital
- Tidelands Georgetown Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.46 of 100
- Quality
- 47.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.42
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.55 of 100
- Quality
- 85
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.83
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36493 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgetown Memorial Hospital | Current | Accepting new patients | |
| Waccamaw Community Hospital | Current | Accepting new patients | |
| Georgetown Memorial Hospital | Current | Accepting new patients |
Locations
606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000
4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100
Interoperability endpoints
- jjohnson447813@direct.musc.edu
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.
-
- Skilled Nursing Facility
- Georgetown, SC
- NPI 1881307056
Hospital & facility affiliations 3
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": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763683200000",
"number": "1265626006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421718",
"city": "GEORGETOWN",
"state": "SC",
"postal_code": "294424203",
"telephone_number": "843-527-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 BLACK RIVER RD",
"city": "GEORGETOWN",
"state": "SC",
"postal_code": "294403368",
"telephone_number": "843-527-7000",
"fax_number": "843-520-8403"
}
],
"practiceLocations": [
{
"address_1": "642 S 2nd St",
"address_2": "Apt 1003",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402022433",
"country_code": "US",
"telephone_number": "623-910-8797",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4070 Highway 17",
"address_purpose": "LOCATION",
"city": "Murrells Inlet",
"state": "SC",
"postal_code": "295765033",
"country_code": "US",
"telephone_number": "843-652-1000",
"fax_number": "843-520-8403",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JAY",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-05",
"last_updated": "2025-11-21",
"certification_date": "2025-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "N6894",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "36493",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218445901",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218445902",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00896831",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jjohnson447813@direct.musc.edu",
"affiliation": "Y",
"affiliationName": "Waccamaw Community Hospital",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4070 Highway 17",
"city": "Murrells Inlet",
"state": "SC",
"country_code": "US",
"postal_code": "295765033",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jjohnson447813@direct.musc.edu",
"affiliation": "Y",
"affiliationName": "Georgetown Memorial Hospital",
"address_1": "606 Black River Rd",
"city": "Georgetown",
"state": "SC",
"country_code": "US",
"postal_code": "294403368",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Georgetown, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.