NPIMap

Individual provider Active NPI

Dustin Johnston

  • Internal Medicine Physician
  • Dalton, GA
National Provider Identifier
1578026530
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
92505 Issued in GA
Practice address
1107 Memorial Dr Ste 200
Dalton, GA 30720-8662
Phone
(706) 226-9355
Fax
(706) 226-9380
NPI assigned
Apr 8, 2019
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 92505 GA Primary

Addresses

Primary practice location

1107 Memorial Dr Ste 200
Dalton, GA 30720-8662

Mailing address

1107 Memorial Dr Ste 200
Dalton, GA 30720-8662
Phone (706) 226-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815002525 GA Practitioner - Internal Medicine 4587997069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hamilton Physician Group, IncGroup PAC ID 4789708553, 120 clinicians

Practice addresses (Care Compare)

1107 Memorial Dr
Suite 200
Dalton, GA 30720-8662
Phone (706) 226-9355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Hamilton Medical Center, Inc. Past Accepting new patients
Paragon Medical Associates Family Medicine PastSince Jul 31, 2022 Accepting new patients

Locations

1107 Memorial Dr
Ste 200
Dalton, GA 30720
Phone (706) 226-9355

1107 Memorial Dr
Ste G2
Dalton, GA 30720
Phone (706) 529-3245

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

Interoperability endpoints

  • Direct secure messaging: djohnston19096@hhcs.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hamilton Medical Center HospiceDalton, GA, CCN 111500 Hospice Corporate Director Jun 22, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1578026530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 200",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-226-9355",
            "fax_number": "706-226-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 200",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-226-9355",
            "fax_number": "706-226-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "DUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "92505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.