NPIMap

Individual provider Active NPI

Diane Lee Johnson, M.D., A.A.F.P.

  • Family Medicine Physician
  • Midlothian, VA
National Provider Identifier
1306839550
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101058870 Issued in VA
Practice address
2367 Colony Crossing PL
Midlothian, VA 23112-4280
Phone
(804) 323-1264
Fax
(804) 323-1276
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101058870 VA Primary

Addresses

Primary practice location

2367 Colony Crossing PL
Midlothian, VA 23112-4280

Mailing address

607 Biggin Pond Rd
Midlothian, VA 23114-4589
Phone (804) 323-1264

Other identifiers 1

IdentifierTypeStateIssuer
VVF389AOtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100722000155 VA Practitioner - Family Practice 3173655446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Primary CareGroup PAC ID 2264420918, 65 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1800 Glenside Dr
Richmond, VA 23226-3769

6800 Woodlake Commons Loop
Midlothian, VA 23112-2281
Phone (804) 302-4589

7140 Hull St Rd
Suite 101
Richmond, VA 23235-5802
Phone (804) 276-4141

9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions15
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058870VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Primary Care Family Medicine CurrentSince Nov 1, 2016 Accepting new patients
Commonwealth Primary Care Family Medicine Past Accepting new patients
Primecare Consulting and Management LLC Family Medicine PastSince May 3, 2020 Accepting new patients

Locations

2367 Colony Crossing Pl
Midlothian, VA 23112
Phone (804) 323-1264

7140 Hull Street Rd
Ste 101
North Chesterfield, VA 23235
Phone (804) 276-4141

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

1800 Glenside Dr
Ste 110
Richmond, VA 23226
Phone (804) 288-1800

Interoperability endpoints

  • Direct secure messaging: diane.johnson@cpcva.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1306839550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 BIGGIN POND RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144589",
            "telephone_number": "804-323-1264",
            "fax_number": "804-323-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 COLONY CROSSING PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124280",
            "telephone_number": "804-323-1264",
            "fax_number": "804-323-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DIANE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D., A.A.F.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101058870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "VVF389A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.