NPIMap

Individual provider Active NPI

Natalie Inge Johnson, M.D.

  • Internal Medicine Physician
  • Tyler, TX
National Provider Identifier
1356351977
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q1633 Issued in TX
Practice address
1000 E 5TH St
Suite 1000
Tyler, TX 75701-3346
Phone
(903) 596-3500
Fax
(903) 596-3553
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD36510 TN
Internal Medicine Physician 207R00000X Q1633 TX Primary

Addresses

Primary practice location

1000 E 5TH St
Suite 1000
Tyler, TX 75701-3346

Mailing address

1000 E. 5TH Street
Suite 400
Tyler, TX 75701
Phone (903) 596-3500

Other identifiers 1

IdentifierTypeStateIssuer
4091459OtherTNBLUE CROSS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103001805 TX Practitioner - Internal Medicine 6800797325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 E 5TH St
Suite 400
Tyler, TX 75701-3362
Phone (903) 596-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue436
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD36510TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince May 1, 2020 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince May 1, 2020 Accepting new patients
Memorial Health Care System Inc. Past Accepting new patients
Starks Medical Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

1000 E 5th St
Ste 400
Tyler, TX 75701
Phone (903) 593-1749

1000 E 5th St
Ste 1000
Tyler, TX 75701

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Interoperability endpoints

  • Direct secure messaging: njohnson355015@ahs.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1356351977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E. 5TH STREET",
            "address_2": "SUITE 400",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-596-3500",
            "fax_number": "903-596-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "address_2": "SUITE 1000",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3500",
            "fax_number": "903-596-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NATALIE",
        "middle_name": "INGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD36510",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q1633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "4091459",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.