J. David Johnson,MD,PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

G7829 Issued in TX

Legal business name

J. DAVID JOHNSON,MD,PA

Practice address

618 S Broadway Ave
Tyler, TX 75701-1665

Phone

(903) 596-9900

Fax

(903) 596-0242

NPI assigned

Jun 14, 2007

Organization subpart

No

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

Authorized official

Name

James M Gordon, NURSE PRACTITIONERNPI 1134121866

Title

Ofc MGR

Phone

(903) 596-9900

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Morris Gordon, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1134121866
  NPD (past) Authorized official
• Jean Ann Harris, RN, FNP-BC

  • Nurse Practitioner
  • Tyler, TX
  • NPI 1508884198
  NPD (past)
• Kenneth Ray Kemp, M.D.

  • Pulmonary Disease Physician
  • Fort Sam Houston, TX
  • NPI 1295726107
  NPD (past)
• Tara Leigh Taylor, M.D.

  • Pulmonary Disease Physician
  • Hickory, NC
  • NPI 1912931213
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1376747196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011665",
            "telephone_number": "903-596-9900",
            "fax_number": "903-596-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011665",
            "telephone_number": "903-596-9900",
            "fax_number": "903-596-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. DAVID JOHNSON,MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFC MGR",
        "authorized_official_telephone_number": "903-596-9900",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G7829",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "K4497",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128264203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Joseph Ittoop, MD
• Leigh S. Ivey, LMSW
• Kelli Emeline Ivy, APRN, FNP-BC
• Meena Iyer
• Ivie Izekor, MD
• J. L. Miguez, Inc., Dba Newsound Hearing Centers
• J. Scott Ellis, D.D.S.
• J. Stuart Crutchfield, M.D.,P.a.
• Jaaca Management Services LLC
• Jaaca Medical

• Specialist in Tyler, TX
• Providers in Tyler, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.