Edward L Johnson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301050587 Issued in MI

Practice address

One Hurley Plaza
Family Ambulatory Clinic
Flint, MI 48503

Phone

(810) 257-9191

Fax

(810) 257-9187

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609920032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 S LINDEN RD",
            "address_2": "SUITE 150",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323421",
            "telephone_number": "810-732-3240",
            "fax_number": "810-230-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HURLEY PLAZA",
            "address_2": "FAMILY AMBULATORY CLINIC",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48503",
            "telephone_number": "810-257-9191",
            "fax_number": "810-257-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301050587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113290",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "OB56031",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinisha Johnson
• Danielle Johnson
• Dawn M Johnson, MS, RD
• Demia Nicole Johnson
• Dominic Johnson
• Gail Lee Johnson, ANP-C
• Gary Keith Johnson, M.D., M.P.H.
• Geron Demarcus Johnson, REGISTERED NURSE
• Heather Diane Johnson, LMSW
• Jaielyn Alexis Johnson

• Internal Medicine Physician in Flint, MI
• Providers in Flint, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.