Active NPI
John Johnson, MD
- Internal Medicine Physician
- Palmetto, FL
National Provider Identifier
1295763456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME23667
- Practice address
- 1515 9TH St W
Palmetto, FL 34221-4463 - Phone
- (941) 981-5643
- Fax
- (941) 981-5644
- NPI assigned
- Jun 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME23667 | FL | Primary |
Addresses
Primary practice location
1515 9TH St W
Palmetto, FL 34221-4463
Mailing address
1515 9TH St W
Palmetto, FL 34221-4463
Phone (941) 981-5643
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001643100 | Medicaid | FL | |
| 110229746 | Other | FL | RAILROAD MEDICARE |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Careservices of Central Florida LLC | Past | Accepting new patients | |
| Mobile Medical Industries Inc | Past | Accepting new patients |
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.
-
- Home Health Agency
- Orlando, FL
- NPI 1295788495
-
- Primary Care Nurse Practitioner
- Boynton Beach, FL
- NPI 1528019247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1295763456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 9TH ST W",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214463",
"telephone_number": "941-981-5643",
"fax_number": "941-981-5644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 9TH ST W",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214463",
"telephone_number": "941-981-5643",
"fax_number": "941-981-5644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME23667",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001643100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110229746",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmetto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.