Active NPI
Richard D. Johnson, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Lumberton, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 0093-00163
- Practice address
- 300 W 27TH St
Lumberton, NC 28358-3075 - Phone
- (910) 671-5000
- NPI assigned
- May 10, 2006
- Last updated
- Jun 29, 2021
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 0093-00163 | NC | Primary |
Addresses
Primary practice location
300 W 27TH St
Lumberton, NC 28358-3075
Mailing address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89130XP | Medicaid | NC | |
| 130XP | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Medical University of South Carolina College of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5189
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0093-00163 | NC | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Pathology Associates PA | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000
5700 Southwyck Blvd
Toledo, OH 43614
Interoperability endpoints
- rjohnson845515@direct.unc.nchie.net
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Unc Health Southeastern | Hospital | Corporate Director | Jan 1, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba UNC Health Southeastern
- General Acute Care Hospital
- Lumberton, NC
- NPI 1427030774
Corporate Director
Organizations & group practices 1
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Lumberton, NC
- NPI 1609825710
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba UNC Health Southeastern
- General Acute Care Hospital
- Lumberton, NC
- NPI 1427030774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1306895719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 SOUTHWYCK BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436141509",
"telephone_number": "800-288-8325",
"fax_number": "419-866-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 27TH ST",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283583075",
"telephone_number": "910-671-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "RICHARD",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NC",
"license": "0093-00163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89130XP",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "130XP",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lumberton, NC
- Grant Hoffman Joerger, CRNA
- Johnson & Johnson Doctors of Optometry, PA (Drs. Johnsons & Johnson EyeWorks)
- Allsion Dawn Johnson, SLP
- Deangila Jenall Johnson, CADC-R
- Larissa Lynn Johnson
- Robert William Johnson, P.A.- C
- Caroline Jolicoeur
- Trevor Augustus Jolly, M.D.
- Brittany Sierra Jones, MSW, LCSWA
- Christina C Jones, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.