Individual provider Active NPI

Dane Todd Johnson, MD

  • Gastroenterology Physician
  • Alpharetta, GA
National Provider Identifier
1497252647
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
100324 Issued in GA
Practice address
3400 Old Milton Pkwy Ste 380
Alpharetta, GA 30005-3707
Phone
(678) 987-1485
Fax
(678) 987-1486
NPI assigned
Apr 12, 2018
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 100324 GA Primary

Addresses

Primary practice location

3400 Old Milton Pkwy Ste 380
Alpharetta, GA 30005-3707

Mailing address

3400 Old Milton Pkwy Ste 380
Alpharetta, GA 30005-3707
Phone (678) 987-1485

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-2490

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240618003649 GA Practitioner - Gastroenterology 0749723724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Georgia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1505 Northside Blvd
Suite 2000
Cumming, GA 30041-6205
Phone (770) 781-4010

3400 Old Milton Pkwy
Alpharetta, GA 30005-3707
Phone (678) 987-1485

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy65
Upper gastrointestinal (GI) endoscopy for acid reflux86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100324GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC Gastroenterology CurrentSince Aug 1, 2024 Accepting new patients
Aga, LLC Gastroenterology CurrentSince Jun 6, 2024 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 380
Alpharetta, GA 30005
Phone (678) 982-1485

1505 Northside Blvd
Ste 2000
Cumming, GA 30041
Phone (770) 781-4010

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

1340 Upper Hembree Rd
Ste A
Roswell, GA 30076
Phone (770) 569-0777

10 Glenlake Pkwy
Ste 900
Sandy Springs, GA 30328

Interoperability endpoints

  • Direct secure messaging: dane.johnson@ud.eclinicaldirectplus.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations & group practices 2

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.

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1497252647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY STE 380",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053707",
            "telephone_number": "678-987-1485",
            "fax_number": "678-987-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY STE 380",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053707",
            "telephone_number": "678-987-1485",
            "fax_number": "678-987-1486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-2490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANE",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "100324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.