David Wesley Johnson, MD
Individual provider Active NPI Family Medicine Physician · Clarksville, TN
NPI 1295882348 · NPPES record last updated Nov 12, 2019
Key facts
- NPI
- 1295882348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 53885 (TN)
- Practice address
- 251 Hillcrest Dr
Clarksville, TN 37043-5086 - Phone
- (931) 245-1150
- Fax
- (931) 245-0605
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Family Practice, PC
Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
1511 Donelson Pkwy
Dover, TN 37058-3749
Phone (931) 232-5555
21 W Roby Dr
Erin, TN 37061-6113
Phone (931) 289-2450
980 Professional Park Dr
Clarksville, TN 37040-5251
Phone (931) 221-9967
Hospital & facility affiliations
- Amedisys Home Health
- Suncrest Home Health
- Vanderbilt Clarksville Hospital
- Tristar Northcrest Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160523001521 | TN | Practitioner - General Practice | 2163325606 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26547 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Family Practice, PC | Family Medicine | Current |
Accepting new patients |
| Ucb Properties LLC | Family Medicine | Past | Accepting new patients |
| Chicora Medical Group PA | Past | Accepting new patients | |
| Shallotte Medical Center Inc | Family Medicine | Past | Accepting new patients |
| Brentwood OB GYN | Past | Accepting new patients | |
| Centennial Heart LLC | Past |
Accepting new patients | |
| Chicora Medical Group PA | Family Medicine | Past | Accepting new patients |
| Delco Health Clinic | Past |
Accepting new patients | |
| First Choice Family Healthcare | Family Medicine | Past | Accepting new patients |
| Shallotte Medical Center Inc | Family Medicine | Past | Accepting new patients |
Locations
1000 Highway 76
Clarksville, TN 37043
Phone (931) 245-1150
236 Uffelman Dr
Clarksville, TN 37043
Phone (931) 647-6305
251 Hillcrest Dr
Clarksville, TN 37043
Phone (931) 245-1150
1011 Highway 76
Ste A
Clarksville, TN 37043
Phone (866) 328-8346
1511 Donelson Pkwy
Dover, TN 37058
Phone (931) 232-5555
21 Roby Dr
Erin, TN 37061
Phone (931) 289-2450
Interoperability endpoints
- david.johnson.1@18155.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26547 | NC | |
| Family Medicine Physician | 207Q00000X | 53885 | TN | Yes |
Addresses
Primary practice location
251 Hillcrest Dr
Clarksville, TN 37043-5086
Mailing address
PO Box 30459
Clarksville, TN 37040-0008
Phone (931) 245-1150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q022939 | Medicaid | TN |
Other providers in Clarksville, TN
- Cynthia Marie Johns
- Deandra Johnson-Barrett
- Alyssa Johnson
- Arionna Johnson
- Beverly Clark Johnson
- Elitha S Johnson
- Elizabeth Johnson
- Erin Azbell Johnson
- Helen Ruth Johnson
- Jessica Elisabeth Johnson
All providers in Clarksville, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.