Gordon Leslie Johnson, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME0063120 Issued in FL

Practice address

10101 W Forest Hill Blvd
Wellington Regional Medical Center Pathology Dept
Wellington, FL 33414

Phone

(561) 798-8559

Fax

(561) 798-8645

NPI assigned

Feb 14, 2006

Last updated

Oct 17, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1316911670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W FOREST HILL BLVD",
            "address_2": "WELLINGTON REGIONAL MEDICAL CENTER PATHOLOGY DEPT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-798-8559",
            "fax_number": "561-798-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W FOREST HILL BLVD",
            "address_2": "WELLINGTON REGIONAL MEDICAL CENTER PATHOLOGY DEPT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-798-8559",
            "fax_number": "561-798-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GORDON",
        "middle_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME0063120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JMHS, Inc.
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• Biju John
• Jennifer John, MD
• Jelisa Johnson
• Jhoni Johnson, ARNP
• Jophin Johnson, FNP-BC,APRN
• Latoya Monique Johnson, PA-C, DHSC
• Richard Stanley Johnson, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Wellington, FL
• Providers in Wellington, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.