Beverly Clark Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD28806 Issued in TN

Practice address

272 Andrew Jackson Dr
Clarksville, TN 37043-1723

Phone

(931) 980-5375

NPI assigned

Aug 2, 2006

Last updated

Jan 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beverly.johnson.1@14940.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/fhir/r4/

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.

• Ambulatory and Occupational Health Clinic PC

  dba DoctorsCare

  • Urgent Care Clinic/Center
  • Clarksville, TN
  • NPI 1649226606
  Medicare reassignment NPD
• Community Health Centers of Western Kentucky, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenville, KY
  • NPI 1306848650
  Medicare reassignment NPD
• Community Health Centers of Western Kentucky, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenville, KY
  • NPI 1164275491
  NPD
• Quality of Life Health Services, Inc

  dba Calhoun Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Anniston, AL
  • NPI 1013339209
  NPD
• Adult Primary Care of Memphis PC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1376738906
  NPD (past)
• Affinity Physician Services LLC

  • General Practice Physician
  • Birmingham, AL
  • NPI 1366485617
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1669489639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 ANDREW JACKSON DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431723",
            "telephone_number": "931-980-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 ANDREW JACKSON DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431723",
            "telephone_number": "931-980-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEVERLY",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD28806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3811144",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64350994",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John T Clardy Sr MD Inc
• Cynthia Marie Johns
• Deandra Johnson-Barrett
• Alyssa Johnson
• Arionna Johnson
• David Wesley Johnson, MD
• Elitha S Johnson
• Elizabeth Johnson, COTA
• Erin Azbell Johnson
• Helen Ruth Johnson, BEHAVIOR TECHNICIAN

• Family Medicine Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.

Verify at the official NPI Registry.