Jeremy Scott Johnson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036136882 Issued in IL

Practice address

611 W. Park St.
OB/GYN
Urbana, IL 61801-2500

Phone

(217) 383-3140

Fax

(217) 383-4966

NPI assigned

Jan 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, TX2 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

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 and National Provider Directory roles.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014
  Medicare reassignment NPD
• Richland Memorial Hospital, Inc

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Medicare reassignment NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  NPD
• Hoopeston Community Memorial Hospital

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD
• Richland Memorial Hospital, Inc

  • Rural Health Clinic/Center
  • Olney, IL
  • NPI 1326566290
  NPD
• Richland Memorial Hospital, Inc

  • Otolaryngology Physician
  • Olney, IL
  • NPI 1700063179
  NPD
• Familycare Associates,PA

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1821161407
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1548249097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "OB/GYN",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3140",
            "fax_number": "217-383-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "20869",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2007-0689",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036136882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37881582",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan J Jimenez, M.D.
• Paul Joffe
• Adam Johnson, PT, CERT MDT
• David A Johnson, OD
• Hannah Danielle Johnson, AGACNP
• Jessica Johnson
• Kylie McKenzie Johnson
• Maddie R Johnson, NP
• Mark August Johnson, M.D.
• Patricia A Johnson, MD

• Obstetrics & Gynecology Physician in Urbana, IL
• Providers in Urbana, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.