Sidney A Johnson Jr., MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

10704 Issued in MS

Practice address

2969 Curran Dr N
Jackson, MS 39216-4121

Phone

(601) 200-3070

NPI assigned

Jun 1, 2005

Last updated

Feb 13, 2023By 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Radiation Oncology

Education

University of Mississippi School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vicksburg Clinic LLCGroup PAC ID 5890696330, 27 clinicians

Radiation Oncology of Mississippi PAGroup PAC ID 6800787961, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• Merit Health Women's Hospital Hospital, Flowood, MS, CCN 250136
• Merit Health River Region Hospital, Vicksburg, MS, CCN 250031
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as apm

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

79.25 of 100Reported as group

Quality

58.5

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158

  Radiation Oncology

  Medicare reassignment Care Compare group NPD
• Radiation Oncology of Mississippi PA

  • Radiation Oncology Physician
  • Jackson, MS
  • NPI 1003905266
  Medicare reassignment Care Compare group
• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Roh LLC

  dba Merit Health Women's Hospital

  • Women's Hospital
  • Jackson, MS
  • NPI 1285681841
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation
• Vicksburg Healthcare LLC

  dba Merit Health River Region

  • General Acute Care Hospital
  • Vicksburg, MS
  • NPI 1215981303
  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1497757603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4997",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964997",
            "telephone_number": "601-362-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 CURRAN DR N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164121",
            "telephone_number": "601-200-3070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2368 Grove St",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391832857",
            "country_code": "US",
            "telephone_number": "601-638-3005",
            "fax_number": "601-638-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SIDNEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "10704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015534",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000015534",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1961809",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497757603",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita F Johnson, LCSW
• Sallie D Johnson
• Sammy Vaun Johnson, AGACNP
• Shacaria Johnson
• Shurunda Johnson
• Stephen D Johnson, FNP
• Stephen J Johnson, LCSW
• Tameka Johnson, RD, CLC, CCP
• Tasha Johnson
• Terrence Zebedee Johnson

• Radiation Oncology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Radiation Oncology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.