Individual provider Active NPI

William C. Johnson III, M.D.

  • Anesthesiology Physician
  • Flowood, MS
National Provider Identifier
1649386392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
14875 Issued in MS
Practice address
1026 N Flowood Dr
Flowood, MS 39232-9532
Phone
(601) 932-1000
NPI assigned
Aug 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 14875 MS Primary

Addresses

Primary practice location

1026 N Flowood Dr
Flowood, MS 39232-9532

Mailing address

PO Box 321360
Flowood, MS 39232-1360
Phone (601) 936-0681

Other identifiers 2

IdentifierTypeStateIssuer
00116953MedicaidMS
05004783OtherMSMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040526000867 MS Practitioner - Anesthesiology 7012998057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tulane University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Anesthesia, PLLCGroup PAC ID 0941102719, 7 clinicians

Practice addresses (Care Compare)

1026 N Flowood Dr
Flowood, MS 39232-9532
Phone (601) 932-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Anesthesia, PLLC Anesthesiology CurrentSince Jul 25, 1996 Accepting new patients

Locations

1026 N Flowood Dr
Jackson, MS 39232
Phone (601) 932-1000

2001 Airport Rd N
Ste 308
Jackson, MS 39232
Phone (601) 936-0681

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649386392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321360",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321360",
            "telephone_number": "601-936-0681",
            "fax_number": "601-936-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 N FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329532",
            "telephone_number": "601-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "C.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "14875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116953",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "05004783",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.