Denise Roberts Johnson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R9G45 Issued in MO

Practice address

6973 Olive Blvd
University City, MO 63130-2540

Phone

(314) 862-7515

Fax

(314) 862-9214

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6053/brand/1/csg/1/fhir/r4

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.

• Johnson Pediatrics, P.C.

  • Pediatrics Physician
  • University City, MO
  • NPI 1790845436
  NPD (past) Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1285793356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6973 OLIVE BLVD",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631302540",
            "telephone_number": "314-862-7515",
            "fax_number": "314-862-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6973 OLIVE BLVD",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631302540",
            "telephone_number": "314-862-7515",
            "fax_number": "314-862-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENISE",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R9G45",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "R9G45",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202402210",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Home DRS Medical Group
• Regina Howard, RDH
• J & P Medical LC
• James E. Bubenik, D.M.D. P.C.
• Johnson Pediatrics, P.C.
• Julie B. Davis, LLC
• Talia Kay
• Kinfolk Mo ABA LLC
• Amanda Jo Kirk, LCSW
• Arthur Krichevsky, PHARM. D.

• Pediatrics Physician in University City, MO
• Providers in University City, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.

Verify at the official NPI Registry.