NPIMap

Individual provider Active NPI

Joel M Johnson III, MD

  • Family Medicine Physician
  • Hilton Head, SC
National Provider Identifier
1619902442
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18011 Issued in SC
Practice address
93 Main St
Hilton Head, SC 29926-1648
Phone
(843) 681-3777
Fax
(843) 681-9996
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30798 GA
Family Medicine Physician 207Q00000X 18011 SC Primary

Addresses

Primary practice location

93 Main St
Hilton Head, SC 29926-1648

Mailing address

93 Main St
Hilton Head, SC 29926-1648
Phone (843) 681-3777

Other identifiers 5

IdentifierTypeStateIssuer
P00335209OtherGARAILROAD MEDICARE
582355948OtherSCBCBS
DA3517OtherSCRR MCR PTAN
P00168790OtherRAILROAD MEDICARE
884046OtherGABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20031118000116 SC Practitioner - General PracticePractitioner - General Surgery 9032023676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Tufts University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Street Medical PCGroup PAC ID 8325952963, 2 clinicians

Practice addresses (Care Compare)

93 Main St
Hilton Head, SC 29926-6613

93 N Main St
Hilton Head, SC 29926-6613
Phone (843) 681-3777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30798GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Medical PC CurrentSince Mar 1, 1998 Accepting new patients
Jesup Emergency Services, LLC Emergency Medicine Past Accepting new patients

Locations

93 Main St
Hilton Head Island, SC 29926
Phone (843) 681-3777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHFHBD

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, 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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1619902442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 MAIN ST",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261648",
            "telephone_number": "843-681-3777",
            "fax_number": "843-681-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 MAIN ST",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261648",
            "telephone_number": "843-681-3777",
            "fax_number": "843-681-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "30798",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00335209",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "582355948",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR PTAN",
            "identifier": "DA3517",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00168790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "884046",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

Verify at the official NPI Registry.