Individual provider Active NPI

William B Johnson, M.D.

  • Pediatrics Physician
  • Fredericksburg, VA
National Provider Identifier
1295715969
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101236688 Issued in VA
Practice address
4532 Plank Rd
Fredericksburg, VA 22407-0139
Phone
(540) 252-1840
Fax
(540) 252-1841
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101236688 VA Primary

Addresses

Primary practice location

4532 Plank Rd
Fredericksburg, VA 22407-0139

Mailing address

4532 Plank Rd
Fredericksburg, VA 22407-0139
Phone (540) 252-1840

Other identifiers 9

IdentifierTypeStateIssuer
CO2375OtherVAMEDICARE GROUP
146228OtherVAANTHEM
3681738OtherVAAETNA HMO
CA9037OtherVAMCR RAILROAD GROUP
010101476MedicaidVA
0101236688OtherVALICENSE
000828306OtherVAAETNA CAP
0005614690OtherVAAETNA NON HMO
8129248OtherVAMAMSI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Doorstep Enterprises Inc Pediatrics Current Accepting new patients
Childrens Clinic of Fredericksburg Urgent Care PC Current Accepting new patients

Locations

4532 Plank Rd
Fredericksburg, VA 22407
Phone (540) 252-1840

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1295715969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224070139",
            "telephone_number": "540-252-1840",
            "fax_number": "540-252-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4532 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224070139",
            "telephone_number": "540-252-1840",
            "fax_number": "540-252-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101236688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "CO2375",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "146228",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3681738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RAILROAD GROUP",
            "identifier": "CA9037",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010101476",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0101236688",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAP",
            "identifier": "000828306",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "0005614690",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "8129248",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.