Active NPI
Philip Edward Johnston, M.D.
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1427045251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01023460A
- Practice address
- 901 Shelby St
Indianapolis, IN 46203-1151 - Phone
- (317) 488-2040
- Fax
- (317) 488-2051
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01023460A | IN | Primary |
Addresses
Primary practice location
901 Shelby St
Indianapolis, IN 46203-1151
Mailing address
3401 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 788-9769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100362240 | Medicaid | IN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01023460A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Family Physicians, Inc. | Family Medicine | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1043275787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1427045251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 E RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462034744",
"telephone_number": "317-788-9769",
"fax_number": "317-781-4868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 SHELBY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031151",
"telephone_number": "317-488-2040",
"fax_number": "317-488-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "PHILIP",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01023460A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100362240",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.