Active NPI
A. Neil Johnson, MD
- Internal Medicine Physician
- Royal Oak, MI
National Provider Identifier
1376746859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301036465
- Practice address
- 3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712 - Phone
- (248) 423-2454
- Fax
- (248) 423-2576
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301036465 | MI | Primary |
Addresses
Primary practice location
3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712
Mailing address
3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712
Phone (248) 423-2454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3143885 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301036465 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William Beaumont Hospital | Internal Medicine | Past | Accepting new patients |
| William Beaumont Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Royal Oak, MI
- NPI 1073562898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376746859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"address_2": "FSC",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-423-2454",
"fax_number": "248-423-2576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"address_2": "FSC",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-423-2454",
"fax_number": "248-423-2576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "A.",
"middle_name": "NEIL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301036465",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3143885",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.