Individual provider Active NPI

Joel M Johnson, MD

  • Surgery Physician
  • Tifton, GA
National Provider Identifier
1649247370
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
030799 Issued in GA
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

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00374646AMedicaidGA

Other names 1

  • Dr. Joel M Johnson Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101208000363 GA Practitioner - General Surgery 2769472687

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Oct 6, 2014 Accepting new patients
Tift Regional Health System Inc Surgery Current Accepting new patients
Tift Regional Health System Inc CurrentSince Oct 6, 2014 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.