Active NPI
Joel M Johnson, MD
- Surgery Physician
- Tifton, GA
National Provider Identifier
1649247370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 030799
- Practice address
- 1007 Greenfield Drive
Tifton, GA 31794-3795 - Phone
- (229) 382-9733
- Fax
- (229) 387-6161
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 030799 | GA | Primary |
Addresses
Primary practice location
1007 Greenfield Drive
Tifton, GA 31794-3795
Mailing address
1007 Greenfield Dr
Tifton, GA 31794-3795
Phone (229) 382-9733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00374646A | Medicaid | GA |
Other names 1
- Dr. Joel M Johnson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | joel.johnson@trhs.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101208000363 | GA | Practitioner - General Surgery | 2769472687 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tift Regional Health System Inc | Current | Accepting new patients | |
| Tift Regional Health System Inc | Surgery | Current | Accepting new patients |
| Tift Regional Health System Inc | Current | Accepting new patients |
Locations
2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188
2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422
1007 Greenfield Dr
Tifton, GA 31794
Phone (229) 382-9733
907 18th St E
Ste 150
Tifton, GA 31794
Phone (229) 353-3422
Interoperability endpoints
- joel.johnson@trhs.cernerdirect.com
Organizations & group practices 3
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.
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-
- Ophthalmology Physician
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- NPI 1790280857
-
- Surgery Physician
- Tifton, GA
- NPI 1912315094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1649247370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 GREENFIELD DR",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943795",
"telephone_number": "229-382-9733",
"fax_number": "229-387-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 GREENFIELD DRIVE",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943795",
"telephone_number": "229-382-9733",
"fax_number": "229-387-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOEL",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "030799",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00374646A",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "joel.johnson@trhs.cernerdirect.com",
"affiliation": "N",
"address_1": "1007 Greenfield Drive",
"city": "Tifton",
"state": "GA",
"country_code": "US",
"postal_code": "317943795",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JOEL",
"last_name": "JOHNSON",
"middle_name": "M",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.