Individual provider Active NPI

Harold V Johnson III, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1497859482
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D5048 Issued in TX
Practice address
800 Eighth Ave
Suite #412
Fort Worth, TX 76104-2618
Phone
(817) 336-0337
Fax
(817) 336-8853
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D5048 TX Primary

Addresses

Primary practice location

800 Eighth Ave
Suite #412
Fort Worth, TX 76104-2618

Mailing address

800 Eighth Ave
Suite #412
Fort Worth, TX 76104-2618
Phone (817) 336-0337

Other identifiers 2

IdentifierTypeStateIssuer
4526152OtherTXAETNA
00N087OtherTXBLUE CROSS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D5048TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harold V. Johnson, III MD PA Internal Medicine PastSince Mar 16, 2004 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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1497859482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 EIGHTH AVE",
            "address_2": "SUITE #412",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042618",
            "telephone_number": "817-336-0337",
            "fax_number": "817-336-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EIGHTH AVE",
            "address_2": "SUITE #412",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042618",
            "telephone_number": "817-336-0337",
            "fax_number": "817-336-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HAROLD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D5048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4526152",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00N087",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.