Individual provider Active NPI

William Michael Johnson, M.D.

  • General Practice Physician
  • Cape Coral, FL
National Provider Identifier
1508851171
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
148661 Issued in FL
Practice address
523 Cape Coral Pkwy E
Cape Coral, FL 33904-8545
Phone
(239) 549-2772
Fax
(239) 549-2332
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38349 KY
Emergency Medicine Physician 207P00000X 38349 KY
General Practice Physician 208D00000X 148661 FL Primary

Addresses

Primary practice location

523 Cape Coral Pkwy E
Cape Coral, FL 33904-8545

Mailing address

523 Cape Coral Pkwy E
Cape Coral, FL 33904-8545
Phone (239) 549-2772

Other identifiers 2

IdentifierTypeStateIssuer
200349100MedicaidIN
64105422MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 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
I20050705000311 KY Practitioner - Emergency MedicinePractitioner - Anesthesiology 1658317359 Reassigns benefits to 2 organizations
I20250521000093 FL Practitioner - General Practice 1658317359 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38349KYMDAnesthesiology Physician
148661FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Correct Care, Inc. Emergency Medicine CurrentSince Feb 5, 2018 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Alan L Tannenbaum MD PA CurrentSince Jun 1, 2025 Accepting new patients
Anesthesia Services of Kentucky, PLLC Anesthesiology Past Accepting new patients

Locations

523 Cape Coral Pkwy E
Cape Coral, FL 33904
Phone (239) 549-2772

4305 New Shepherdsville Rd
Bardstown, KY 40004
Phone (502) 350-5000

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

850 Riverview Ave
Pineville, KY 40977
Phone (606) 337-3051

1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1508851171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048545",
            "telephone_number": "239-549-2772",
            "fax_number": "239-549-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048545",
            "telephone_number": "239-549-2772",
            "fax_number": "239-549-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "38349",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "38349",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "148661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200349100",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64105422",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.