Individual provider Active NPI

Rachel L. Johnson, D.O.

  • Family Medicine Physician
  • Lewisburg, WV
National Provider Identifier
1629063532
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2283 Issued in WV
Practice address
1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone
(304) 645-3220
Fax
(844) 479-4545
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2283 WV Primary

Addresses

Primary practice location

1464 Jefferson St N
Lewisburg, WV 24901-1380

Mailing address

1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone (304) 645-3220

Other identifiers 1

IdentifierTypeStateIssuer
3810011302MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20080228000685 WV Practitioner - Family Practice 4385543586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia School of Osteopathic Medicine Clinic IncGroup PAC ID 0941113427, shared by 2 NPIs, 33 clinicians

Practice addresses (Care Compare)

1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone (304) 645-3220

Hospital & facility affiliations

  • Camc Greenbrier Valley Medical Center, Inc Hospital, Ronceverte, WV, CCN 510002
  • Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia School of Osteopathic Medicine Clinic Inc Family Medicine CurrentSince Jul 30, 2023 Accepting new patients
West Virginia School of Osteopathic Medicine Clinic Inc D/B/a Robert C. Byrd Clinic Family Medicine CurrentSince Feb 4, 2007 Accepting new patients
Bucyrus Community Hospital LLC Past Accepting new patients
New Washington Medical Practice Family Medicine PastSince Dec 1, 2003 Accepting new patients

Locations

1464 Jefferson St N
Lewisburg, WV 24901
Phone (304) 647-5577

Interoperability endpoints

  • Direct secure messaging: rachel.johnson.1@17660.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1629063532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "844-479-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "844-479-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RACHEL",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011302",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.