Active NPI
Pierre M Johnson, M.D.
- Internal Medicine Physician
- Fairbanks, AK
National Provider Identifier
1447353743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 6017
- Practice address
- 2555 Phillips Field Rd
Fairbanks, AK 99709-3933 - Phone
- (907) 328-2920
- Fax
- (907) 456-2914
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5263105-1205 | UT | |
| Internal Medicine Physician | 207R00000X | 6017 | AK | Primary |
Addresses
Primary practice location
2555 Phillips Field Rd
Fairbanks, AK 99709-3933
Mailing address
2555 Phillips Field Rd
Fairbanks, AK 99709-3933
Phone (907) 328-2920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080129000769 | AK | Practitioner - Internal Medicine | 9830271808 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6017 | AK | MD | Licensed Practical Nurse |
| 5263105-1205 | UT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pierre M Johnson, MD PC | 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.
-
- Medical Specialty Clinic/Center
- Fairbanks, AK
- NPI 1720486814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1447353743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 PHILLIPS FIELD RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093933",
"telephone_number": "907-328-2920",
"fax_number": "907-456-2914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 PHILLIPS FIELD RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093933",
"telephone_number": "907-328-2920",
"fax_number": "907-456-2914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PIERRE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "5263105-1205",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AK",
"license": "6017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.