Gil Johnson, M.D.
Individual provider Active NPI Adult Medicine Physician · Conway, AR
NPI 1356563241 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1356563241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- MC1518 (AR)
- Practice address
- 2511 A College Ave
Conway, AR 72034-6135 - Phone
- (501) 327-6041
- Fax
- (501) 327-6043
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2511 College Ave
Suite a
Conway, AR 72034-6273
Phone (501) 924-6041
Hospital & facility affiliations
- Conway Regional Homecare SVCS
- Gentiva
- Conway Regional Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060508000983 | AR | Practitioner - Family Practice |
9133139421 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC1518 | AR | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Park Family Clinic PA | Adult Medicine | Current |
Accepting new patients |
Locations
2511 College Ave
Ste A
Conway, AR 72034
Phone (501) 327-6041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | MC1518 | AR | Yes |
Addresses
Primary practice location
2511 A College Ave
Conway, AR 72034-6135
Mailing address
2511 A College Ave
Conway, AR 72034-6135
Phone (501) 327-6041
Other providers in Conway, AR
- Cierra Johnson
- Corey Amber Johnson
- Debra Johnson
- Dexter Johnson
- Fernando Johnson
- Henry Johnson
- Jeff Johnson
- Johanna Johnson
- John M Johnson
- Jordan Nichole Johnson
All providers in Conway, AR · Adult Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.