Individual provider Active NPI

Sairah Johnson, MD

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1447868583
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024036353 Issued in MO
Practice address
900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469
Phone
(573) 815-6640
Fax
(573) 815-6644
NPI assigned
Jul 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2024036353 MO
Family Medicine Physician 207Q00000X 2024036353 MO Primary

Addresses

Primary practice location

900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469

Mailing address

900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469
Phone (573) 815-6640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20241022002038 MO Practitioner - Family Practice 3476085911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

900 W Nifong Blvd
Suite 101
Columbia, MO 65203-4469
Phone (573) 815-6640

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024036353MOMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

900 W Nifong Blvd
Ste 101
Columbia, MO 65203
Phone (573) 499-9009

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

Interoperability endpoints

  • Direct secure messaging: sjohnson429961@direct.ahsys.org

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.

Hospital & facility affiliations 2

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1447868583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034469",
            "telephone_number": "573-815-6640",
            "fax_number": "573-815-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034469",
            "telephone_number": "573-815-6640",
            "fax_number": "573-815-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAIRAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2024036353",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024036353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.