Organization Active NPI

Johnson Medical Center of Venice, Inc.

  • Family Medicine Physician
  • Venice, FL
National Provider Identifier
1578622981
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHNSON MEDICAL CENTER OF VENICE, INC.
Practice address
401 Johnson LN
Suite 101
Venice, FL 34285-6280
Phone
(941) 484-5333
Fax
(941) 488-2834
NPI assigned
Dec 8, 2006
Last updated
Dec 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Jeffrey P. Johnson, DCNPI 1538273339
Title
Owner/Provider
Phone
(941) 484-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH5308 FL
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH 8175 FL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME90236 FL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

401 Johnson LN
Suite 101
Venice, FL 34285-6280

Mailing address

401 Johnson LN
Suite 101
Venice, FL 34285-6280
Phone (941) 484-5333

Other identifiers 1

IdentifierTypeStateIssuer
1144549163OtherFLNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040921000693 FL Part B Supplier - Clinic/Group Practice 2062480700 Receives reassigned benefits from 10 practitioners
Practice locations: Venice, FL
O20200418000223 FL DME Supplier - Medical Supply Company 2062480700 Practice locations: Venice, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Johnson Medical CNTR of Venice, Inc401 Johnson LN, Venice, FL 34285-6369(941) 484-5333 Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory

Locations

401 Johnson Ln
Ste 101
Venice, FL 34285
Phone (813) 484-5333

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1578622981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 JOHNSON LN",
            "address_2": "SUITE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342856280",
            "telephone_number": "941-484-5333",
            "fax_number": "941-488-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 JOHNSON LN",
            "address_2": "SUITE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342856280",
            "telephone_number": "941-484-5333",
            "fax_number": "941-488-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON MEDICAL CENTER OF VENICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "941-484-5333",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5308",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 8175",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME90236",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144549163",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.