Individual provider Active NPI

Lynn R Johnson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Greenville, NC
National Provider Identifier
1508835091
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
9701780 Issued in NC
Practice address
2080 W Arlington Blvd Ste B
Greenville, NC 27834-3770
Phone
(252) 752-2140
Fax
(252) 689-6502
NPI assigned
Mar 16, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9701780 NC
Pain Medicine (Anesthesiology) Physician 207LP2900X 9701780 NC Primary

Addresses

Primary practice location

2080 W Arlington Blvd Ste B
Greenville, NC 27834-3770

Mailing address

2080 W Arlington Blvd Ste B
Greenville, NC 27834-3770
Phone (252) 752-2140

Other identifiers 5

IdentifierTypeStateIssuer
195409OtherNCMEDCOST
11578OtherNCBCBS OF NC
1508835091OtherNCTRICARE
8911578MedicaidNC
P00303989OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060427000608 NC Practitioner - Anesthesiology 3971513458 Reassigns benefits to 2 organizations
I20201223000659 VA Practitioner - Anesthesiology 3971513458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Pittsburgh School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

211 Virginia Rd
Edenton, NC 27932-9668
Phone (252) 482-1606

229 Clearfield Ave
Suite 200
Virginia Beach, VA 23462-1815
Phone (757) 312-6300

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701780NCMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Jan 1, 2006 Accepting new patients
The Outer Banks Hospital Inc CurrentSince Feb 1, 2016 Accepting new patients
The Outer Banks Hospital Inc Anesthesiology CurrentSince Feb 1, 2016 Accepting new patients
Coastal Pain Medicine, LLC Anesthesiology Past Accepting new patients

Locations

2080 W Arlington Blvd
Ste B
Greenville, NC 27834
Phone (252) 752-2140

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2430 Emerald Pl
Ste 201
Greenville, NC 27834
Phone (252) 752-2140

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

3714 Guardian Ave
Ste W
Morehead City, NC 28557
Phone (252) 247-0314

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

2410 Montgomery Dr SW
Wilson, NC 27893
Phone (252) 291-5940

1037 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 491-3535

229 Clearfield Ave
Ste 200
Virginia Beach, VA 23462
Phone (757) 312-6300

Interoperability endpoints

  • Direct secure messaging: ljohnson13704@direct.ecuhealth.com

Organizations & group practices 4

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 4

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1508835091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343770",
            "telephone_number": "252-752-2140",
            "fax_number": "252-689-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343770",
            "telephone_number": "252-752-2140",
            "fax_number": "252-689-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LYNN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "9701780",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "9701780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "195409",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "11578",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1508835091",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911578",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00303989",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.