NPIMap

Individual provider Active NPI

Amanda Dawn Johnson, M.D.

  • Family Medicine Physician
  • Batesville, AR
National Provider Identifier
1629489133
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E9615 Issued in AR
Practice address
1710 Harrison St
Batesville, AR 72501-7303
Phone
(870) 262-1200
NPI assigned
May 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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 E9615 AR Primary

Addresses

Primary practice location

1710 Harrison St
Batesville, AR 72501-7303

Mailing address

PO Box 2197
Batesville, AR 72503-2197
Phone (870) 262-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160916000300 AR Practitioner - Family PracticePractitioner - Emergency Medicine 6507170255 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

3443 Harrison St
Batesville, AR 72501-8820
Phone (870) 262-1510

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E9615ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Rehab Group LLP Family Medicine CurrentSince Feb 20, 2017 Accepting new patients
St Bernards Hospital Inc CurrentSince Aug 3, 2016 Accepting new patients
White River Health System, Inc. CurrentSince Jul 1, 2017 Accepting new patients
White River Health System, Inc. Family Medicine Past Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

Organizations & group practices 5

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1629489133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2197",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032197",
            "telephone_number": "870-262-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "870-262-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E9615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

Verify at the official NPI Registry.