Individual provider Active NPI

J Barry Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Winston-Salem, NC
National Provider Identifier
1396717005
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
75 Issued in NC
Practice address
3314 Healy Dr
Suite 102
Winston-Salem, NC 27103-1408
Phone
(336) 768-1267
Fax
(336) 768-9336
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 75 NC
Foot & Ankle Surgery Podiatrist 213ES0103X 75 NC Primary

Addresses

Primary practice location

3314 Healy Dr
Suite 102
Winston-Salem, NC 27103-1408

Mailing address

3314 Healy Dr
Suite 102
Winston-Salem, NC 27103-1408
Phone (336) 768-1267

Other identifiers 1

IdentifierTypeStateIssuer
8908095MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
75NCMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Associates of Winston Salem , Inc. Foot & Ankle Surgery CurrentSince Apr 30, 2003 Accepting new patients

Locations

3314 Healy Dr
Winston Salem, NC 27103
Phone (336) 768-1267

3314 Healy Dr
Ste 102
Winston Salem, NC 27103
Phone (336) 682-8659

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396717005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 HEALY DR",
            "address_2": "SUITE 102",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271031408",
            "telephone_number": "336-768-1267",
            "fax_number": "336-768-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 HEALY DR",
            "address_2": "SUITE 102",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271031408",
            "telephone_number": "336-768-1267",
            "fax_number": "336-768-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "J",
        "middle_name": "BARRY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "75",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "75",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908095",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.