Individual provider Active NPI

William H. Johnstone, M.D.

  • Diagnostic Radiology Physician
  • Bristol, TN
National Provider Identifier
1417958091
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
14736 Issued in TN
Practice address
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone
(423) 968-1144
Fax
(423) 968-3453
NPI assigned
Aug 9, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 14736 TN Primary

Addresses

Primary practice location

1 Medical Park Blvd
Bristol, TN 37620-7430

Mailing address

3053 W State St
Bristol, TN 37620-1720
Phone (423) 968-1144

Other identifiers 7

IdentifierTypeStateIssuer
R07104OtherTNJOHN DEERE
305839OtherTNBC BS
3193652MedicaidTN
7213387MedicaidVA
0177567000MedicaidWV
242047OtherVAANTHEM BCBS
64219066MedicaidKY

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417958091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201720",
            "telephone_number": "423-968-1144",
            "fax_number": "423-968-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-968-1144",
            "fax_number": "423-968-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTONE",
        "first_name": "WILLIAM",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "14736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "R07104",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "305839",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3193652",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7213387",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177567000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM  BCBS",
            "identifier": "242047",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64219066",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.