NPIMap

Individual provider Active NPI

Jeray James Johnson, MD

  • Pulmonary Disease Physician
  • Duluth, MN
National Provider Identifier
1629181706
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
44733 Issued in MN
Practice address
920 E 1St St
P201
Duluth, MN 55805-2201
Phone
(218) 249-7970
Fax
(218) 249-7949
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 44733 MN Primary

Addresses

Primary practice location

920 E 1St St
P201
Duluth, MN 55805-2201

Mailing address

920 E 1St St
P201
Duluth, MN 55805-2201
Phone (218) 249-7970

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070417000355 NC Practitioner - Internal MedicinePractitioner - Pulmonary Disease 8022113208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hugh Chatham Memorial Hospital, Inc.Group PAC ID 2062311442, 75 clinicians

Practice addresses (Care Compare)

180 Parkwood Dr
Elkin, NC 28621-2430
Phone (336) 527-7298

Hospital & facility affiliations

  • Hugh Chatham Memorial Hospital Hospital, Elkin, NC, CCN 340097
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Chatham Memorial Hospital, Inc. Current Accepting new patients
Hugh Chatham Memorial Hospital, Inc Pulmonary Disease CurrentSince Oct 1, 2022 Accepting new patients
Hugh Chatham Memorial Hospital, Inc CurrentSince Oct 1, 2022 Accepting new patients
WRMC Hospital Operating Corporation Past Accepting new patients

Locations

180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000

100 Chatham Medical Park
Elkin, NC 28621
Phone (336) 526-0188

500 Chatham Medical Park
Elkin, NC 28621
Phone (336) 835-3136

360 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-5960

5229 Rock Creek Rd
Hays, NC 28635
Phone (336) 696-2711

Interoperability endpoints

  • Direct secure messaging: jejohnson@hcn.gwaydirect.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 7

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1629181706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "P201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-7970",
            "fax_number": "218-249-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "P201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-7970",
            "fax_number": "218-249-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JERAY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "44733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "920 E 1st St",
            "address_2": "P201",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.