Individual provider Active NPI

Michael Eric Johnson, PHARMD

  • Pharmacist
  • Lake City, FL
National Provider Identifier
1467850974
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS46612 Issued in FL
Practice address
161 SW Stonegate Ter
Suite 105
Lake City, FL 32024-3452
Phone
(386) 754-5377
Fax
(386) 487-0309
NPI assigned
Dec 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS46612 FL Primary

Addresses

Primary practice location

161 SW Stonegate Ter
Suite 105
Lake City, FL 32024-3452

Mailing address

161 SW Stonegate Ter
Suite 105
Lake City, FL 32024-3452
Phone (386) 754-5377

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS46612FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cheek & Scott Drugs Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1467850974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 SW STONEGATE TER",
            "address_2": "SUITE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243452",
            "telephone_number": "386-754-5377",
            "fax_number": "386-487-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 SW STONEGATE TER",
            "address_2": "SUITE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243452",
            "telephone_number": "386-754-5377",
            "fax_number": "386-487-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS46612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.