NPIMap

Individual provider Active NPI

John T. Johnson, M.D.

  • Family Medicine Physician
  • Crestview, FL
National Provider Identifier
1437128469
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME49715 Issued in FL
Practice address
550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430
Phone
(850) 682-6122
Fax
(850) 682-5917
NPI assigned
Mar 14, 2006
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME49715 FL Primary

Addresses

Primary practice location

550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430

Mailing address

PO Box 2699
Pensacola, FL 32513-2699

Other identifiers 1

IdentifierTypeStateIssuer
048472500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070207000327 FL Practitioner - Family PracticePractitioner - Internal Medicine 0143298018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575

5045 Carpenter Creek Dr
Pensacola, FL 32503-2521
Phone (850) 416-7548

550 Redstone W Ave
Crestview, FL 32536-6429

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Family Medicine CurrentSince Oct 1, 2012 Accepting new patients
Sacred Heart Health System Inc CurrentSince Oct 1, 2012 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

550 Redstone Ave W
Ste 200
Crestview, FL 32536
Phone (850) 682-6122

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4586 E Highway 20
Ste B
Niceville, FL 32578
Phone (850) 897-3200

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

5045 Carpenter Creek Dr
Pensacola, FL 32503
Phone (850) 416-2400

Interoperability endpoints

  • Direct secure messaging: john.johnson.1@9582.direct.athenahealth.com
  • Direct secure messaging: jtjohnso@yourcarecommunity.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1437128469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 200",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366430",
            "telephone_number": "850-682-6122",
            "fax_number": "850-682-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME49715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048472500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.