Earlie T Johnson Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31729 Issued in NC

Practice address

2580 Henderson Dr
Jacksonville, NC 28546-5252

Phone

(910) 346-1188

Fax

(910) 346-1275

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: ejohnson@goshenmedical.cloudcraftdirect.com

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.

• Family Urgent Care of America, Inc

  • Non-Pharmacy Dispensing Site
  • Holly Ridge, NC
  • NPI 1972657302
  NPD (past) Authorized official
• Richlands Healthcare, P.C.

  • Physician Assistant
  • Richlands, NC
  • NPI 1164619532
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1275594079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 COUNTRY CLUB DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467420",
            "telephone_number": "910-347-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465252",
            "telephone_number": "910-346-1188",
            "fax_number": "910-346-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EARLIE",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "31729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0154H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890154H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson Drug Williamsburg Inc.
• Johnson Westpark Drugs
• Jade Angelique Johnson-Grant
• Anishia Johnson
• Dornecia Johnson
• Ellie Marie Johnson, PT, DPT
• Hayley Johnson
• Jamie Johnson
• Janet Johnson, MD
• Lauren Johnson, CNM, WHNP-BC, RN

• Internal Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.