Graham Oliver Childs Johnson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD451937 Issued in PA

Practice address

5800 Walnut St
Rear (Sayre Health Center)
Philadelphia, PA 19139-3836

Phone

(215) 474-4444

NPI assigned

Jun 17, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Marlboro Home health agency, Upper Marlboro, MD, CCN 217047
• Medstar Health Home Care Home health agency, Hyattsville, MD, CCN 217150

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
• FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Family Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Sayre Health Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1831209113
  NPD (past)

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

• Adoration Home Health Care Maryland, LLC

  dba Adoration home Health Marlboro

  • Home Health Agency
  • Upper Marlboro, MD
  • NPI 1467147934
  Care Compare affiliation
• Medstar Health Visiting Nurse Association, Inc.

  dba MedStar Health Home Care

  • Home Health Agency
  • Greenbelt, MD
  • NPI 1154437879
  Care Compare affiliation

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1467747436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WALNUT ST",
            "address_2": "REAR (SAYRE HEALTH CENTER)",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393836",
            "telephone_number": "215-474-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 WALNUT ST",
            "address_2": "REAR (SAYRE HEALTH CENTER)",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393836",
            "telephone_number": "215-474-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 Exton Square Mall",
            "address_purpose": "LOCATION",
            "city": "Exton",
            "state": "PA",
            "postal_code": "193412440",
            "country_code": "US",
            "telephone_number": "484-421-1669",
            "fax_number": "610-903-1084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GRAHAM",
        "middle_name": "OLIVER CHILDS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD451937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "154 Exton Square Mall",
            "city": "Exton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "193412440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erika Scott Johnson, MS,MD
• Fabrian Lamont Johnson Jr., MS
• Frances Johnson
• Frank W Johnson, CSW
• Frederick B Johnson, MD PHD
• Gregory Johnson, MD
• Gregory Johnson, M.D.
• Haley Johnson, PHARMD
• Henry Breavoid Johnson, OTR
• Jacoba Johnson, PHD

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.