Douglas William Johnson, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

ME43406 Issued in FL

Practice address

7015 A C Skinner Pkwy BLDG 100
Jacksonville, FL 32256-6932

Phone

(904) 516-3737

Fax

(904) 516-3738

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Practice roles

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.

• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  Medicare reassignment NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Rehabilitation Hospital Unit
  • Waycross, GA
  • NPI 1548322084
  NPD
• Cancer Services of Aventura LLC

  • Diagnostic Radiology Physician
  • Aventura, FL
  • NPI 1790973063
  NPD (past)
• Integrated Community Oncology Network LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
  • NPI 1043230402
  NPD (past)
• Memorial Southside Cancer Center LLC

  • Radiation Oncology Clinic/Center
  • Jacksonville, FL
  • NPI 1588724033
  NPD (past)
• North Florida Cancer Center Live Oak LLC

  • Radiation Oncology Physician
  • Live Oak, FL
  • NPI 1730176215
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497712384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19675",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459675",
            "telephone_number": "904-309-8680",
            "fax_number": "904-345-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY BLDG 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-516-3737",
            "fax_number": "904-516-3738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 San Marco Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078554",
            "country_code": "US",
            "telephone_number": "904-202-7020",
            "fax_number": "904-202-7029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME43406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03911",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AJ038S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00191285",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "040225",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853120709A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046276400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derekia Johnson
• Diana L Johnson, M.D.
• Dianne Laroche Johnson, M.D.
• Dominque Johnson
• Donald Wayne Johnson Jr., PHARMD
• Elizabeth Johnson, MD
• Elizabeth Mary Johnson, M.D.
• Emily Dunn Johnson
• Eric Michael Johnson, LMHC
• Erika N Johnson, B.A.

• Radiation Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.