Individual provider Active NPI

Andrea S. Johnson, MD

  • Obstetrics & Gynecology Physician
  • Dallas, TX
National Provider Identifier
1265694723
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P3359 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 645-3838
Fax
(214) 645-3839
NPI assigned
Jun 26, 2008
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X P3359 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 648-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120815000451 TX Practitioner - Obstetrics/Gynecology 1456507961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-2700

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2012 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology CurrentSince Jul 1, 2012 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients
Dallas County Hospital District Past Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1265694723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-3280",
            "fax_number": "214-648-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-3838",
            "fax_number": "214-645-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P3359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.