NPIMap

Individual provider Active NPI

Russell Johnson

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1336102375
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34-00-7168 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 291-4101
NPI assigned
Apr 10, 2006
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34-00-7168 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other identifiers 7

IdentifierTypeStateIssuer
341960760035OtherOHCARESOURCE
2228753MedicaidOH
000000271437OtherOHANTHEM
000000372951OtherOHANTHEM
727174OtherOHBCHP
810547599042MedicaidOH
4429949MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050121000261 OH Practitioner - Emergency Medicine 8628981735 Reassigns benefits to 4 organizations
I20190905001430 MI Practitioner - Emergency Medicine 8628981735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Toledo HospitalGroup PAC ID 2961309638, 118 clinicians
Emergency Physicians of Northwest Ohio, Inc.Group PAC ID 3375456478, 102 clinicians

Practice addresses (Care Compare)

1075 Medical Ctr Pkwy
Maumee, OH 43537
Phone (567) 585-0800

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.25 of 100Reported as group
Quality
96.55
Improvement activities
40
Cost
89.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Northwest Ohio Inc. Emergency Medicine CurrentSince Apr 18, 2002 Accepting new patients
The Toledo Hospital CurrentSince Nov 9, 2022 Accepting new patients
Joint Township District Memorial Hospital CurrentSince Feb 3, 2018 Accepting new patients
Observation Physicians of Northwest Ohio LLC Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients
The Toledo Hospital CurrentSince Nov 9, 2022 Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Riverwood Emergency Services Inc. Emergency Medicine Past Accepting new patients
JTDM Family Practice LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Fostoria Hospital Association Past Accepting new patients
Emergency Physicians of Northwest Ohio, LLC Emergency Medicine Past Accepting new patients

Locations

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

455 W 4th St
Ste 10
Fostoria, OH 44830
Phone (419) 436-8320

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1075 Medical Center Pkwy
Maumee, OH 43537
Phone (567) 585-0800

200 Saint Clair Ave
Saint Marys, OH 45885
Phone (419) 394-3387

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 12

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 2

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1336102375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RUSSELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-00-7168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341960760035",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2228753",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000271437",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000372951",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHP",
            "identifier": "727174",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810547599042",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4429949",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.