Charles H Johnson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

17178 Issued in AZ

Practice address

830 Ainsworth Drive
Prescott, AZ 86301-1614

Phone

(928) 776-0325

Fax

(928) 776-0405

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DermatologyAlso: Internal Medicine

Education

George Washington University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prescott Medical and Dermatology GroupGroup PAC ID 4688057201, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: charles.johnson@pmadg-az.direct.office.nextgen.com

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.

• Prescott Medical and Dermatology Group

  • Dermatology Physician
  • Prescott, AZ
  • NPI 1841929908
  Medicare reassignment Care Compare group NPD

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

• Yavapai Community Hospital Association

  dba Yavapai Regional Medical Center

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1336129667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 AINSWORTH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011630",
            "telephone_number": "928-776-0325",
            "fax_number": "928-776-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 AINSWORTH DRIVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "928-776-0325",
            "fax_number": "928-776-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 S Candy Ln Ste 14",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863264120",
            "country_code": "US",
            "telephone_number": "928-639-3387",
            "fax_number": "928-634-0311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 N Glassford Hill Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142256",
            "country_code": "US",
            "telephone_number": "928-772-8553",
            "fax_number": "928-772-3861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18325 N Allied Way Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850543107",
            "country_code": "US",
            "telephone_number": "928-776-0325",
            "fax_number": "928-776-0405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "17178",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "17178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282731",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John P Passamani MD PA
• John R Markham PC (Prescott Vision and Eye Surgery Center)
• John R. Markham PC (Prescott Vision & Eye Surgery Center)
• Christopher Aaron Johns, M.D.
• Brent E Johnson, M.D.
• Jacqueline J Johnson, LPC
• Karen Marie Johnson, MD
• Lindsey Allyson Johnson, FNP-C
• Rachel Johnson
• Ray W. Johnson, M.D.

• Dermatology Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.