Jerri L. Johnson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0049721 Issued in FL

Practice address

411 Maitland Ave
Suite 1001
Altamonte Springs, FL 32701-5448

Phone

(407) 260-2606

Fax

(407) 260-6339

NPI assigned

Dec 6, 2005

Last updated

Dec 17, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerrijohnsonmd@altamontedermatology.emadirect.md

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.

• Healthcare Colleagues PA

  • Dermatology Physician
  • Altamonte Springs, FL
  • NPI 1245953215
  NPD

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1588648265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MAITLAND AVE",
            "address_2": "SUITE 1001",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015448",
            "telephone_number": "407-260-2606",
            "fax_number": "407-260-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAITLAND AVE",
            "address_2": "SUITE 1001",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015448",
            "telephone_number": "407-260-2606",
            "fax_number": "407-260-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JERRI",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0049721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058049000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De'Ja Johnson
• Felina Johnson
• Frank Johnson Jr.
• Jamie Ann Johnson, BSN
• Jeannie Marie Johnson, DC
• Keeley Nicole Johnson, D.P.T
• Kristin Michelle Johnson, M.A., IMH 9941
• Lily Johnson
• Matthew Johnson
• Regan Johnson, PA-C

• Specialist in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.