Individual provider Active NPI

Elston Royce Johnson

  • Cardiovascular Disease Physician
  • Columbus, OH
National Provider Identifier
1568854065
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34.013504 Issued in OH
Practice address
5100 W Broad St
Columbus, OH 43228-1607
Phone
(614) 544-1000
Fax
(614) 544-1751
NPI assigned
Feb 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34.013504 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5100 W Broad St
Columbus, OH 43228-1607

Mailing address

71 Bills BR
Logan, WV 25601-3141
Phone (304) 590-3417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210729001550 OH Practitioner - Cardiovascular Disease (Cardiology) 3678849015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
West Virginia School of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

955 Bethesda Dr
FL 1
Zanesville, OH 43701-1873
Phone (740) 454-0804

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group, LLC CurrentSince Jul 26, 2021 Accepting new patients
Genesis Medical Group LLC Cardiovascular Disease CurrentSince Jul 26, 2021 Accepting new patients

Locations

61353 Southgate Rd
Ste 5
Cambridge, OH 43725
Phone (740) 421-9240

48439 Genesis Dr
Ste F
Coshocton, OH 43812
Phone (740) 623-4481

301 Mike Clouse Dr
#2A
Somerset, OH 43783
Phone (740) 836-0035

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

955 Bethesda Dr
Fl 1
Zanesville, OH 43701
Phone (740) 454-0804

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1568854065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BILLS BR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013141",
            "telephone_number": "304-590-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELSTON",
        "middle_name": "ROYCE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-21",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34.013504",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.