Organization Active NPI

Premila Johnson, MD LP

  • Internal Medicine Physician
  • Midland, TX
National Provider Identifier
1396007274
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M3739 Issued in TX
Legal business name
PREMILA JOHNSON, MD LP
Practice address
2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808
Phone
(432) 413-5496
NPI assigned
Jun 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Dr. Premila Lakshmi Singh Johnson, MDNPI 1184727562
Title
Physician/Owner
Phone
(432) 413-5496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X M3739 TX Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X M3739 TX

Addresses

Primary practice location

2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808

Mailing address

2300 W Michigan Ave
Suite 5
Midland, TX 79701-5808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000579 TX Part B Supplier - Clinic/Group Practice 2860658499 Receives reassigned benefits from 2 practitioners
Practice locations: Midland, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2048045Premila Johnson, MD, LP2300 W Michigan Ave, Suite 5, Midland, TX 79701Certificate of waiverOct 8, 2026

National Provider Directory

National Provider Directory

Locations

2300 W Michigan Ave
Ste 5
Midland, TX 79701
Phone (432) 413-5496

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1396007274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W MICHIGAN AVE",
            "address_2": "SUITE 5",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W MICHIGAN AVE",
            "address_2": "SUITE 5",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015808",
            "telephone_number": "432-413-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMILA JOHNSON, MD LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PREMILA",
        "authorized_official_middle_name": "LAKSHMI SINGH",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "432-413-5496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3739",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M3739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.