NPIMap

Organization Active NPI

Johnston Memorial Hospital

Doing business as Hospitalist of Johnston Memorial Hospital

  • Hospitalist Physician
  • Abingdon, VA
National Provider Identifier
1386834547
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0101221395 Issued in VA
Legal business name
JOHNSTON MEMORIAL HOSPITAL
Doing business as
Hospitalist of Johnston Memorial Hospital
Practice address
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone
(276) 258-4050
Fax
(276) 258-4056
NPI assigned
Jul 25, 2007
Last updated
Feb 14, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNSTON MEMORIAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
John L Jeter
Title
Cfo
Phone
(276) 258-2830

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002132 VA
Hospitalist Physician 208M00000X 0101239640 VA
Hospitalist Physician 208M00000X 0101238469 VA
Hospitalist Physician 208M00000X 0101237946 VA
Hospitalist Physician 208M00000X 0101221395 VA Primary

Addresses

Primary practice location

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664

Mailing address

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-4050

Other identifiers 5

IdentifierTypeStateIssuer
618072300OtherVADOL/ENERGY & FECA
1104812684MedicaidVA
032157100OtherVABLACK LUNG
1525980MedicaidTN
CB9307OtherVARR MEDICARE

Other names 1

  • HOSPITALIST OF JOHNSTON MEMORIAL HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Johnston Memorial Hospital9 organizations share this tax ID, including this one
Part of
Johnston Memorial Hospital

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1386834547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-4050",
            "fax_number": "276-258-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-4050",
            "fax_number": "276-258-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSTON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNSTON MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2007-07-25",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "276-258-2830"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002132",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101239640",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101238469",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101237946",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101221395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL/ENERGY & FECA",
            "identifier": "618072300",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104812684",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "032157100",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525980",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CB9307",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPITALIST OF JOHNSTON MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.