Individual provider Active NPI

Matthew Robert Johnson, M.D.

  • Anesthesiology Physician
  • Hickory, NC
National Provider Identifier
1356577464
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2013-00960 Issued in NC
Practice address
415 N Center St
Suite 201
Hickory, NC 28601-5057
Phone
(828) 327-8105
Fax
(828) 327-4245
NPI assigned
Jun 3, 2009
Last updated
May 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2013-00960 NC Primary

Addresses

Primary practice location

415 N Center St
Suite 201
Hickory, NC 28601-5057

Mailing address

415 N Center St
Suite 201
Hickory, NC 28601-5057
Phone (828) 327-8105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20130628000803 NC Practitioner - Anesthesiology 9234379926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
JC Edwards School of Medicine, Marshall University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1031 Morganton Blvd SW
Lenoir, NC 28645-5677
Phone (828) 757-6254

214 19TH St SE
Hickory, NC 28602-1369
Phone (240) 566-1629

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

321 Mulberry St SW
Lenoir, NC 28645-5720
Phone (828) 757-5100

420 N Ctr St
Hickory, NC 28601-5033
Phone (828) 315-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00960NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients

Locations

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

Organizations & group practices 1

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1356577464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "SUITE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015057",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "SUITE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015057",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2013-00960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.