Samuel Johnson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

037841 Issued in GA

Practice address

5300 Memorial Dr
Suite 112
Stone Mountain, GA 30083-3148

Phone

(678) 704-0306

NPI assigned

Sep 19, 2007

Last updated

Sep 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Hope Medical Group Inc

  dba Hope Medical Group, P.C.

  • Psychiatry Physician
  • Stone Mountain, GA
  • NPI 1154399210
  Authorized official Same address or phone
• Hope Medical, LLC

  • Family Medicine Physician
  • Stone Mountain, GA
  • NPI 1124425483
  Authorized official Same address or phone

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1477749810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "address_2": "SUITE 112",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833148",
            "telephone_number": "678-704-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "address_2": "SUITE 112",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833148",
            "telephone_number": "678-704-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "037841",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "037841",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "037841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford L Johnson, EDD, LPC
• Gladys B Johnson
• Jazmine Johnson
• Michelle Allison Johnson, REGISTERED NURSE
• Rourger Lynn Johnson, O.D.
• Teresa A Johnson, MS, LPC, NCC
• Violet Oluyinka Jonah
• Jones Cody Personal Care Home Inc
• Chatice Jones, PHLEBOTOMIST
• Danielle Yvette Jones, MEDICAL ASSISTANT

• Family Medicine Physician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.

Verify at the official NPI Registry.