Zackery Johnson, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4395 Issued in WV

Practice address

1320 Maplewood Ave
Ronceverte, WV 24970-8016

Phone

(043) 647-4411

NPI assigned

May 12, 2021

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

Medicare fee-for-service enrollment

Enrolled in WV

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

Emergency Medicine

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Camc Greenbrier Valley Medical Center IncGroup PAC ID 1254702962, 79 clinicians

Oak Hill Emergency Physicians, LLCGroup PAC ID 8123292950, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camc Greenbrier Valley Medical Center, Inc Hospital, Ronceverte, WV, CCN 510002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Camc Greenbrier Valley Medical Center Inc

  • Cardiovascular Disease Physician
  • Ronceverte, WV
  • NPI 1588373872

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Oak Hill Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Oak Hill, WV
  • NPI 1891075057
  Medicare reassignment Care Compare group NPD
• Camc Greenbrier Valley Medical Center, Inc.

  • Rural Health Clinic/Center
  • Peterstown, WV
  • NPI 1588485478
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Camc Greenbrier Valley Medical Center Inc

  • General Acute Care Hospital
  • Ronceverte, WV
  • NPI 1679299408
  Care Compare affiliation

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1407430721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "043-647-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ZACKERY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT020569",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "4395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Honaker
• Chelsea Hubner, DPT
• Tia Humphreys, LPN
• Isaac Kenneth Hurst, M.D.
• Steve Alvin Johnson, MD MBA
• Stephanie Johnston, RN
• Megan E Jones, LPC
• Ray L. Jones, D.O.
• Tony Wayne Jones
• Bailee Judy, AGPCNP

• Emergency Medicine Physician in Ronceverte, WV
• Providers in Ronceverte, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.