Charles E Johnson Jr., DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3516 Issued in AL

Practice address

Bryce Hospital
200 University Blvd
Tuscaloosa, AL 35401-1205

Phone

(205) 759-0799

Fax

(205) 759-0845

NPI assigned

Aug 21, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1346356599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011205",
            "telephone_number": "205-759-0799",
            "fax_number": "205-759-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRYCE HOSPITAL",
            "address_2": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011205",
            "telephone_number": "205-759-0799",
            "fax_number": "205-759-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51000265",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009947605",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jim Myers Drug, Inc.
• Jim Myers Drug, Inc.
• Jim Myers Orthotics & Prosthetics, LLC
• Johnson & Marshall, PC
• Johnson CRF LLC
• Chase Johnson
• Colleen Ruth Johnson, PT
• Dawn L Johnson, O.D.
• Ellory Kate Johnson, MD
• Ernest Van Johnson, M.D.

• Dentist in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.