Jonathon Edward Josephson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

87691 Issued in SC

Practice address

325 MDG, 340 Magnolia Cir
Tyndall Afb, FL 32403-5604

Phone

(850) 283-7918

NPI assigned

Feb 26, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1548894793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324035604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MDG, 340 MAGNOLIA CIR",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPHSON",
        "first_name": "JONATHON",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "87691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Randall Heil, M.D.
• Matthew Hetrick, IDMT
• Brittany Lynn Holm, OD
• Fred Kendall Johnson, DPT
• Kimberly Susan Johnson, M.D.
• Robert Sebastian Kent, M.D.
• Christine Kersten
• Eric James Kirwan, LISW
• Elizabeth P. Kuss, N.P.
• Nicholas Ian Longstreet, M.D.

• Family Medicine Physician in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.