John R. Johnson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21412 Issued in KY

Practice address

95 Bryan Blvd
Corbin, KY 40701-2788

Phone

(606) 526-4590

Fax

(606) 526-0548

NPI assigned

Nov 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200
  NPD

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417028762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BRYAN BLVD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012788",
            "telephone_number": "606-526-4590",
            "fax_number": "606-526-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": "21412",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "21412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LIC#",
            "identifier": "21412",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittani Michelle Johnson, BS
• Charles Crit Johnson, BS
• Hannah Mackenzie Johnson, MA, LPCC
• Herbert Dale Johnson, BS, RPH
• Holly Johnson, PT
• Katherine Johnson
• Kayla Danielle Johnson, BS
• Kori Johnson
• Leslie Marie Johnson, BA, QMRP
• Mallory Quinn Johnson, RN

• Family Medicine Physician in Corbin, KY
• Providers in Corbin, KY by specialty
• Family Medicine Physician in Kentucky

• 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.