Jordan Lloyd Johnson, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

9302 Issued in KY

Practice address

2232 Bardstown Rd Ste a
Louisville, KY 40205-1986

Phone

(270) 438-3060

NPI assigned

May 20, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1366888174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 W MAIN ST",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421641120",
            "telephone_number": "701-339-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 BARDSTOWN RD STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051986",
            "telephone_number": "270-438-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Leigh Johnson, PHARMD
• Jill Johnson, DNP, APRN, FNP-BC
• John Johnson, OD
• John R. Johnson, M.D.
• Jolean Johnson, RN
• Justin Lynn Johnson, RADPSS
• Kalee Ann Johnson, MSSW, CSW
• Karen Marie Johnson, OTR/L
• Karin Johnson, D.O.
• Katelyn Johnson, RN

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.