NPIMap

Individual provider Active NPI

David Wesley Johnson, MD

  • Family Medicine Physician
  • Clarksville, TN
National Provider Identifier
1295882348
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53885 Issued in TN
Practice address
251 Hillcrest Dr
Clarksville, TN 37043-5086
Phone
(931) 245-1150
Fax
(931) 245-0605
NPI assigned
Jan 4, 2007
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26547 NC
Family Medicine Physician 207Q00000X 53885 TN Primary

Addresses

Primary practice location

251 Hillcrest Dr
Clarksville, TN 37043-5086

Mailing address

PO Box 30459
Clarksville, TN 37040-0008
Phone (931) 245-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523001521 TN Practitioner - General Practice 2163325606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Family Practice, PCGroup PAC ID 6305839093, 15 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26547NCMDAddiction (Substance Use Disorder) Counselor
53885TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Family Practice, PC Family Medicine CurrentSince Dec 5, 2016 Accepting new patients
Delco Health Clinic PastSince Jan 1, 1990 Accepting new patients
Centennial Heart LLC PastSince Nov 17, 2019 Accepting new patients
Brentwood OB GYN Past Accepting new patients
Shallotte Medical Center Inc Family Medicine Past Accepting new patients
Shallotte Medical Center Inc Family Medicine Past Accepting new patients
Chicora Medical Group PA Past Accepting new patients
Ucb Properties LLC Family Medicine Past Accepting new patients
Chicora Medical Group PA Family Medicine Past Accepting new patients
First Choice Family Healthcare Family Medicine Past Accepting new patients

Locations

1000 Highway 76
Clarksville, TN 37043
Phone (931) 245-1150

1011 Highway 76
Ste A
Clarksville, TN 37043
Phone (866) 328-8346

236 Uffelman Dr
Clarksville, TN 37043
Phone (931) 647-6305

251 Hillcrest Dr
Clarksville, TN 37043
Phone (931) 245-1150

1511 Donelson Pkwy
Dover, TN 37058
Phone (931) 232-5555

Interoperability endpoints

  • Direct secure messaging: david.johnson.1@18155.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1295882348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30459",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400008",
            "telephone_number": "931-245-1150",
            "fax_number": "931-245-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 HILLCREST DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435086",
            "telephone_number": "931-245-1150",
            "fax_number": "931-245-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "26547",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "53885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.