Glenn Richard Johnston, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0018091 Issued in FL

Practice address

2304 Aloma Ave
Winter Park, FL 32792-3330

Phone

(407) 478-8840

Fax

(407) 478-8841

NPI assigned

Dec 19, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396808184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVENEUE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-478-8840",
            "fax_number": "407-478-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923330",
            "telephone_number": "407-478-8840",
            "fax_number": "407-478-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "GLENN",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0018091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME0018091",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew David Johnson, A.P.
• Michael W Johnson, R.PH
• Robin Janee Johnson, M.S.
• Sharika S. Johnson, LMHC
• Travone Jonathon Johnson
• Joie de Vivre Health and Chiropractic, LLC
• Jon S Wilkins, D.D.S., P.a.
• Jonathan Schwartzman PA
• Anita Jones, ARNP
• Anne-Marie V Jones, MD

• Family Medicine Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Family Medicine Physician in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.