Individual provider Active NPI

William Holland Johnson Jr., MD

  • Surgery Physician
  • Suwanee, GA
National Provider Identifier
1669422010
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
057867 Issued in GA
Practice address
6920 McGinnis Ferry Rd Ste 340
Suwanee, GA 30024-6675
Phone
(770) 232-2911
Fax
(770) 232-2996
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 057867 GA Primary

Addresses

Primary practice location

6920 McGinnis Ferry Rd Ste 340
Suwanee, GA 30024-6675

Mailing address

9710 Almaviva Dr
Johns Creek, GA 30022-4989
Phone (404) 983-6759

Other identifiers 1

IdentifierTypeStateIssuer
5901911MedicaidNC

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
I20060802000360 GA Practitioner - General Surgery 5294760716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Johns Creek Surgery PCGroup PAC ID 8426061722, 4 clinicians

Practice addresses (Care Compare)

6920 McGinnis Ferry Rd
Suite 340
Suwanee, GA 30024-6675
Phone (770) 232-2911

Hospital & facility affiliations

  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
057867GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Creek Surgery PC Surgery CurrentSince Aug 1, 2006 Accepting new patients
Atlanta General and Bariatric Surgery Center, LLC PastSince May 1, 2013 Accepting new patients

Locations

3890 Johns Creek Pkwy
Ste 240
Suwanee, GA 30024
Phone (404) 994-4561

6920 McGinnis Ferry Rd
Ste 340
Suwanee, GA 30024
Phone (770) 232-2911

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1669422010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 ALMAVIVA DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300224989",
            "telephone_number": "404-983-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 MCGINNIS FERRY RD STE 340",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246675",
            "telephone_number": "770-232-2911",
            "fax_number": "770-232-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WILLIAM",
        "middle_name": "HOLLAND",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "057867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901911",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.