Individual provider Active NPI

David H Johnson, MD

  • Family Medicine Physician
  • Buchanan, VA
National Provider Identifier
1508837741
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-231013 Issued in VA
Practice address
18080 Main St
Buchanan, VA 24066-5482
Phone
(540) 254-1239
NPI assigned
Jan 27, 2006
Last updated
May 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101-231013 VA Primary

Addresses

Primary practice location

18080 Main St
Buchanan, VA 24066-5482

Mailing address

5814 Cavalier Dr
Roanoke, VA 24018-3870

Other identifiers 3

IdentifierTypeStateIssuer
010194962MedicaidVA
010112907MedicaidVA
1508837741MedicaidVA

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
0101-231013VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Emergency Services, Inc. Family Medicine Past Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Carilion Emergency Services, Inc. PastSince Dec 17, 2023 Accepting new patients
Carilion Medical Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1508837741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5814 CAVALIER DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18080 MAIN ST",
            "city": "BUCHANAN",
            "state": "VA",
            "postal_code": "240665482",
            "telephone_number": "540-254-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-231013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010194962",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010112907",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508837741",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buchanan, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.