Active NPI
Charles E. Johnson II, M.D.
- Pediatrics Physician
- South Williamson, KY
National Provider Identifier
1659309367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25945
- Practice address
- 306 Hospital Dr
South Williamson, KY 41503-4095 - Phone
- (606) 237-1766
- Fax
- (606) 237-1790
- NPI assigned
- Jun 29, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25945 | KY | Primary |
Addresses
Primary practice location
306 Hospital Dr
South Williamson, KY 41503-4095
Mailing address
306 Hospital Dr
South Williamson, KY 41503-4095
Phone (606) 237-1766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25945 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc. | Past | Accepting new patients | |
| Appalachian Regional Healthcare, Inc. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- charlesjohnson@arh.medalliesdirect.net
Organizations & group practices 2
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.
-
- Clinical Pathology/Laboratory Medicine Physician
- Whitesburg, KY
- NPI 1417045998
-
dba Tug Valley ARH Regional Medical Center
- Anatomic Pathology & Clinical Pathology Physician
- South Williamson, KY
- NPI 1679658199
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659309367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 HOSPITAL DR",
"city": "SOUTH WILLIAMSON",
"state": "KY",
"postal_code": "415034095",
"telephone_number": "606-237-1766",
"fax_number": "606-237-1790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 HOSPITAL DR",
"city": "SOUTH WILLIAMSON",
"state": "KY",
"postal_code": "415034095",
"telephone_number": "606-237-1766",
"fax_number": "606-237-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CHARLES",
"middle_name": "E.",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "25945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Williamson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.