Derek K. Johnson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD40831 Issued in TN

Practice address

300 Stonecrest Blvd Ste 250
Smyrna, TN 37167-6832

Phone

(629) 220-0211

Fax

(629) 220-0210

NPI assigned

Mar 22, 2006

Last updated

Oct 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Pediatric Medicine

Education

University of Pittsburgh School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derekjohnson@mmcsc.allscriptsdirect.net
• FHIR API: https://fhir4.healow.com/fhir/r4/BGEICD/Endpoint/BGEICD

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.

• The Center for Pediatric Excellence, PLLC

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1386382273
  Medicare reassignment NPD Authorized official
• HCA Health Services of Tennessee, Inc.

  dba TriStar StoneCrest Medical Center

  • General Acute Care Hospital
  • Smyrna, TN
  • NPI 1992776405
  NPD (past)
• Saint Thomas Rutherford Hospital

  dba Ascension Saint Thomas Rutherford

  • General Acute Care Hospital
  • Murfreesboro, TN
  • NPI 1164590386
  NPD (past)
• Geisinger Clinic

  • Family Medicine Physician
  • Pottsville, PA
  • NPI 1043261183

  Pediatrics

  NPD (past)
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1386603850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 250",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676832",
            "telephone_number": "629-220-0211",
            "fax_number": "629-220-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 250",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676832",
            "telephone_number": "629-220-0211",
            "fax_number": "629-220-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEREK",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD073165L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD40831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001842036",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Jefferson, M.D.
• Jeffrey a Larsen MD PLLC (Jeffrey A Larsen MD)
• Ashley Jenkins
• John M. Byrnes, MD
• Cyrah Johnson
• Grant Johnson, D.O.
• Juli Johnson, LPC
• Krystal Jade Johnson
• Willow Johnson
• Amy Jones

• Pediatrics Physician in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.